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Volume 31, Number 2—February 2025
Synopsis

Two Human Cases of Fatal Meningoencephalitis Associated with Potosi and Lone Star Virus Infections, United States, 2020–2023

Charles Y. ChiuComments to Author , Raja Rama Godasi, Holly R. Hughes, Venice Servellita, Kafaya Foresythe, Asritha Tubati, Kelsey Zorn, Sukhman Sidhu, Michael R. Wilson, Sai Varun Bethina, Daniel Abenroth, Yee Cheng, Raymond Grams, Camilla Reese, Carlos Isada, and Neeharika Thottempudi
Author affiliation: Chan–Zuckerberg Biohub, San Francisco, California, USA (C.Y. Chiu); Abbott Pandemic Defense Coalition, Abbott Park, Illinois, USA (C.Y. Chiu, V. Servellita, K. Foresythe); University of California, San Francisco (C.Y. Chiu, V. Servellita, K. Foresythe, A. Tubati, K. Zorn, S. Sidhu, M.R. Wilson); St. Luke’s Boise Medical Center, Boise, Idaho, USA (R. Rama Godasi, D. Abenroth, Y. Cheng, R. Grams, C. Reese); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (H.R. Hughes); Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA (S. Varun Bethina); Cleveland Clinic, Cleveland, Ohio, USA (C. Isada); University of Nevada, Reno, Nevada (N. Thottempudi)

Main Article

Table

Laboratory test results for 2 patients with bunyavirus-associated meningoencephalitis, United States, 2020–2023*

Case-patient and test performed Sample type Test site No. tests Result
Case-patient 1
Bacterial, fungal, or AFB culture CSF, blood C, T 4 Negative
Mayo autoimmune or neoplastic panel CSF, serum Mayo 6 Negative
Cryptococcal antigen CSF, serum C 3 Negative
Neurosyphilis test CSF, serum C 3 Negative
FilmArray M/E panel CSF C 3 Negative
HIV-1 serologic test Serum C 1 Negative
Lyme disease serologic test Serum C 1 Negative
Hepatitis A–C serologic test Serum C 1 Negative
WNV PCR CSF T 1 Negative
HSV-1/2 PCR CSF T 1 Negative
VZV PCR CSF T 1 Negative
HHV-6 PCR CSF T 1 Negative
Parvovirus B19 PCR CSF T 1 Negative
Toxoplasma gondii PCR CSF T 1 Negative
Histoplasma capsulatum PCR CSF T 1 Negative
H. capsulatum IgG or IgM CSF, serum T 2 Negative
Coccidioides IgG or IgM CSF, serum T 2 Negative
Adenovirus PCR CSF T 1 Negative
(1,3)-𝛽-D glucan assay CSF, serum T 2 Negative
Cytologic test CSF T 1 Negative
mNGS pathogen diagnosis CSF UCSF 2 POTV detected; reads from all 3 segments (S, M, and L)
mNGS
 CSF
 CDC
 1
 POTV detected; reads from 2 segments (S and L)
Case-patient 2
Bacterial, fungal, or AFB culture CSF, blood T 3 Negative
Mayo autoimmune/neoplastic panel CSF, serum Mayo 1 Elevated GAD65 antibody in serum†
Cryptococcal antigen CSF, serum C 3 Negative
Histoplasma urinary antigen Urine T 1 Negative
Lyme disease serologic test Serum T 1 Negative
Babesia spp. PCR CSF T 1 Negative
Toxoplasma gondii PCR CSF T 1 Negative
Histoplasma capsulatum PCR CSF T 1 Negative
H. capsulatum IgG or IgM CSF, serum T 2 Negative
WNV PCR CSF T 1 Negative
HSV-1/2 PCR CSF T 1 Negative
FilmArray M/E panel CSF T 1 Negative
VZV PCR CSF T 1 Negative
HHV-6 PCR CSF T 1 Negative
mNGS pathogen diagnosis CSF UCSF 2 LSV detected; reads from all 3 segments (S, M, and L)
Virus isolation CSF CDC 1 Negative
mNGS CSF CDC 1 Negative (no reads to LSV)
PRNT CSF, serum CDC 1 Negative

*AFB, acid-fast bacilli; C, community hospital; CDC, Centers for Disease Control and Prevention; HHV-6, human herpesvirus 6; HSV, herpes simplex virus; GAD65, glutamic acid decarboxylase 65; L, large; LSV, Lone star virus; M, medium; M/E, meningitis/encephalitis; Mayo, Mayo Clinic; mNGS, metagenomic next-generation sequencing; POTV, Potosi virus; PRNT, plaque reduction neutralizing testing; S, small; T, tertiary care hospital; UCSF, University of California San Francisco; VZV, varicella zoster virus; WNV, West Nile virus. †0.37 nmol/L (reference range <0.02 nmol/L).

Main Article

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