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01.12.2018 | Case report | Ausgabe 1/2018 Open Access

BMC Infectious Diseases 1/2018

Persistent mammalian orthoreovirus, coxsackievirus and adenovirus co-infection in a child with a primary immunodeficiency detected by metagenomic sequencing: a case report

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2018
Autoren:
Dagmara W. Lewandowska, Riccarda Capaul, Seraina Prader, Osvaldo Zagordi, Fabienne-Desirée Geissberger, Martin Kügler, Marcus Knorr, Christoph Berger, Tayfun Güngör, Janine Reichenbach, Cyril Shah, Jürg Böni, Andrea Zbinden, Alexandra Trkola, Jana Pachlopnik Schmid, Michael Huber
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12879-018-2946-7) contains supplementary material, which is available to authorized users.

Abstract

Background

We report a rare case of Mammalian orthoreovirus (MRV) infection in a child with a primary immunodeficiency (PID). Infections with Mammalian orthoreovirus are very rare and probably of zoonotic origin. Only a few cases have been described so far, including one with similar pathogenesis as in our case.

Case presentation

The patient, age 11, presented with flu-like symptoms and persistent severe diarrhea. Enterovirus has been detected over several months, however, exact typing of a positive cell culture remained inconclusive. Unbiased metagenomic sequencing then detected MRV in stool samples from several time points. The sequencing approach further revealed co-infection with a recombinant Coxsackievirus and Adenovirus. MRV-specific antibodies detected by immunofluorescence proved that the patient seroconverted.

Conclusion

This case highlights the potential of unbiased metagenomic sequencing in supplementing routine diagnostic methods, especially in situations of chronic infection with multiple viruses as seen here in an immunocompromised host. The origin, transmission routes and implications of MRV infection in humans merit further investigation.
Zusatzmaterial
Additional file 1: Portable Document Format. Table S1. Routine screening results for Enterovirus. Figures S1 to S9. Phylogenetic analyses of all Mammalian orthoreovirus segments isolated in this study. Figure S10. Coxsackievirus BLAST genotyping. Figure S11. Coxsackievirus Bootscan Analysis. Supplementary Methods. Supplementary References. (PDF 456 kb)
12879_2018_2946_MOESM1_ESM.pdf
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