Sequencing of the pus from a patients with brain abscess

Brain abscess is a suppurative infection of brain tissue caused by one or more pathogens under specific susceptible conditions and is associated with a high clinical fatality rate. Beyond surgical intervention, the identification of pathogens is crucial to effective clinical antimicrobial therapy, yet this remains a significant challenge. We present a rare case of multiple brain abscesses caused by Nocardia asiatica co-infection with Torque teno virus (TTV) in an immunocompetent patient with suspected multiple organ involvement. The patient was diagnosed with multiple brain abscesses. Under general anesthesia, robot-assisted stereotactic drainage of the intracranial abscesses was performed. During the procedure, pale-yellow pus was aspirated. A portion of the aspirate was sent for metagenomic next-generation sequencing (mNGS) analysis, which identified gene sequences from N. asiatica and TTV.