PMC8795075_01
The plain CT brain imaging on the 8th day (A), 15th day (B), 19th day (C), and 24th day (D) after initial symptoms.
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F1
Some minor cuts were found on his left hand (Supplementary Figure 1). On day 8, Plain CT brain imaging was still normal after initial symptoms (admission day) (Figure 1A). On day 15, after initial symptoms, Plain CT brain imaging showed patchy hypo-density in the bilateral frontotemporal lobe (Figure 1B). On day 19, CT brain imaging showed multiple patchy hypo-density in right basal ganglia, left thalamus, bilateral frontotemporal lobe, and bilateral insular lobe (Figure 1C). On day 24, the lesion site of CT brain is basically the same as before (Figure 1D), which indicated that the present treatment might not be effective.
Findings of mNGS and PCR confirmation; (A,B) mNGS results of the CSF. (C,D) mNGS results of the aqueous humor; (E) Gel electrophoresis of PCR products; (F) Sanger sequencing result; Genome coverage rate is total length of detected sequences dividing by the length of published genome sequence. The "AH," "CSF," "NC," and "M" represent aqueous humor, cerebrospinal fluid, negative control, and marker, respectively.
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F2
A total of 652 unique reads mapped to the Suid alphaherpesvirus 1 genome out of 15,970 microbial reads (Figure 2A) with a genome coverage rate of 25.3% (Figure 2B) in CSF sample, whereas only one unique read of Suid alphaherpesvirus 1 in blood sample was detected, which might be due to the low concentration of viral DNA in blood. Notably, mNGS of aqueous humor sample detected 1,566 unique reads (0.42%, 1,566/368,878) (Figure 2C) aligned to the Suid alphaherpesvirus 1 genome with a genome coverage rate of 35% (Figure 2D). Furthermore, PCR targeting glycoprotein B (gB) gene of Suid alphaherpesvirus 1 showed that fragments of about 194 bp in length were successfully amplified from CSF and aqueous humor samples (Figure 2E). MK806387.1) was 99% (Figure 2F).