Case report: Clinical characteristics of anthrax meningoencephalitis: two cases diagnosed using metagenomic next-generation sequencing and literature review.

Purpose: To explore the clinical features, diagnosis, treatment, and prognosis of anthrax meningoencephalitis. Methods: The clinical data of two cases of anthrax meningoencephalitis were summarized and the relevant literature was reviewed. Results: Both patients, who were farmers, had cutaneous lesions prior to the onset of meningoencephalitis. The clinical manifestations included fever (2/2), headache (2/2), stupor (2/2), meningeal signs (2/2), and lymph node enlargement (2/2). The CSF analysis showed erythrocytes, increased neutrophils, low glucose levels and high protein levels. CSF cytology revealed rod-shaped bacilli. Metagenomic next-generation sequencing of the CSF from both patients detected Conclusion: Anthrax meningoencephalitis typically presents as a rapidly progressive bacterial meningoencephalitis. The occurrence of stupor, agitation and intracranial hemorrhage is possibly correlated with poor outcome. Two types of bactericidal drugs or intrathecal injection drugs are associated with better prognosis. Metagenomic next-generation sequencing can quickly and accurately detect