by neversaydie on 4/30/25, 7:56 AM with 80 comments
by w10-1 on 5/4/25, 5:51 AM
Metagenomics are particularly good in cases like this where tissue samples are small. These spirochete are too small for light microscopy - probably why the lab missed them.
by dtech on 5/4/25, 1:47 AM
by uxhacker on 5/4/25, 6:08 AM
For example, the Earlham Institute, the University of Oxford, and the UK Health Security Agency are all actively involved in metagenomics research and surveillance.
For example: https://www.phgfoundation.org/blog/metagenomic-sequencing-in...
https://www.earlham.ac.uk/events/nanopore-metagenomics-sampl...
by donatj on 5/4/25, 12:49 PM
After five years they'd never tried a broad-spectrum antibiotic treatment? That's the real story here.
by loremm on 5/4/25, 5:05 PM
Not viral/bacterial but human mutations but this is an inspiring study --- https://pubmed.ncbi.nlm.nih.gov/31019026/ , https://radygenomics.org/2021/13-hours-rady-childrens-instit...
A child is born with potential rare genetic disease. They sequence their DNA within 13 hours and come back with a diagonsis in some proportion of cases (they give lots of stats, it's small sample size, maybe 1/4 improved outcomes, maybe 2/3 have immediate change to their care)
by bsder on 5/4/25, 5:02 AM
Leptospirosis is known to be both prevalent in tropical areas and to be difficult to positively culture and identify.
by patrickhogan1 on 5/4/25, 4:57 PM
by sleepyguy on 5/4/25, 6:11 AM
In Canada, when a complex issue like this arises, it's common to see several different specialists; the testing is typically very thorough, even including some forms of genetic testing. They do everything they can to get you off the steroids, knowing it will cause issues if taken long-term.
by epmaybe on 5/4/25, 7:44 PM
The timeline for delayed immune reaction to a leptospirosis infection makes diagnosis incredibly difficult. There was no mention of an acute febrile illness preceding this during the patient's trip to the tropics, which I assume a uveitis specialist would ask.
While empiric treatment with doxycycline wouldn't be a bad idea, you have to decide what to empirically treat with, and for how long, and what the ramifications of increasing resistance to antibiotics are for society. Do I commit a patient to the hospital for two weeks of IV penicillin because I "suspect" syphilis? of course not.
Better diagnostics for these occult diseases should be applauded. But we shouldn't be vilifying the clinicians that are by all accounts doing their best.
by pton_xd on 5/4/25, 5:37 AM
Don't doctors always ask about international travel when you present with an unknown illness? The exact timeline is difficult to infer from the article but that seems like pretty important detail to overlook.
by animal531 on 5/4/25, 11:49 AM
But the problem is that it generates a ton of eye strain for some reason, so now I'm on eye drops probably every 30 to 45 minutes and if I don't take them my eyes become really sore and useless.
At least I'm working for myself so its less of a hassle, but taking constant breaks to rest the eyes isn't great for productivity.
by greg on 5/5/25, 2:36 AM
I always keep metagenomics in mind now for friends and family who have mystery ailments.
by raincom on 5/4/25, 2:51 AM
"Metagenomics technology uses cutting-edge genomic sequencing, which can identify all bacteria, fungi or parasites present in a sample by comparing them against a database of millions of pathogens.
[if you] do a separate test for each and every one and if you've got an infection with something that's unexpected, rare or not previously known, you won't find it."