PMC9634161_01
Head MRI of the patient before surgery. (A) coronal view; (B) sagittal section view; (C) axial view; (D) ventricular enlargement in coronal view
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F1
Here, we report a 15-year-old female patient who was presented to a local hospital in 2018 due to headache and vomiting (Supplementary Figure 1). MRI (Figure 1) of the head at our hospital showed bilateral cerebellopontine angle (CPA) and fourth ventricle occupying lesions with a high likelihood of ventricular meningioma recurrence and hydrocephalus.
Brain CT of the patient in different stages of the disease. (A, B): Postoperative CT of the patient. (C) On the 17th postoperative day, the patient's head CT after left ventriculocentesis. (D) On the 27th postoperative day, the patient's head CT after left ventriculocentesis.
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F2
Tomography (CT) showed a "post-occipital craniotomy" status, enlargement of the ventricular system, and a slight intracerebroventricular hyperintensity (Figures 2A,B). The patient was conscious on the first postoperative day, with a temperature of 39 A left ventricular puncture and drainage procedure was performed due to the progressive hydrocephalus (Figure 2C) on the seventeenth postoperative day. However, right ventricular puncture and drainage was performed on the twenty-seventh postoperative day due to suspected hydrocephalus according to head CT, which showed an enlarged right ventricle (Figure 2D).
A. baumannii coverage map of mNGS detection in different periods. (A) The first mNGS of CSF: 99,343 specific sequences of A. baumannii, with a coverage of 54.3%; (B) The second mNGS of CSF: 88,618 specific sequences and 68.32% coverage; (C, D) The third mNGS of CSF and blood: 857 (coverage 1.66%) and 446 (coverage 0.93%) specific reads, respectively.
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F3
CSF mNGS results revealed 99,343 specific sequences of A. baumannii, with a coverage of 54.3% (Figure 3A). Carbapenem resistance genes blaOXA-23 (36 reads) and blaOXA-51 (15 reads) were also detected (Table 1). The second CSF mNGS result still revealed A. baumannii with 88,618 specific sequences and 68.32% coverage (Figure 3B). Drug-resistant genes (gyrA by CSF, and parC and gyrA by blood, all were 1 sequence) were also detected by both blood and CSF mNGS (Figures 3C,D).