Using next-generation sequencing to find infectious causes of acute encephalitis and myelitis in Guadeloupe

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This prospective observational project will apply next-generation DNA/RNA sequencing to cerebrospinal fluid and other clinical samples from patients presenting with acute encephalitis or myelitis at the University Hospital of Guadeloupe. Patients who meet clinical inclusion criteria will have NGS performed to search for viral, bacterial, parasitic, or fungal pathogens that standard serology and PCR tests do not identify. The study builds on a four-year retrospective series that found no pathogen in 45% of cases locally and aims to produce more complete epidemiological data on infectious causes in the French West Indies. Findings are intended to improve diagnostic accuracy, guide targeted treatment, and help detect emerging or tropical-specific pathogens.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* We selected the following eligibility criteria for patients with acute encephalitis:

  * Patient of at least 28 days of life
  * With acute onset of symptoms for more than 24 hours
  * A major criterion among the following:
* a disorder of consciousness or alertness
* memory disorder
* lethargy
* modification of personal or behavioral disorder, irritability
* confusion, disorientation in time or space

  \- At least two of the following minor criteria:
* temperature above 38 ° C
* new onset focal neurological deficit
* epileptic crisis
* biological abnormality of CSF (≥ 5 Leukocytes / mm3, protein ≥ 0.40 g / L)
* partial or general epileptic seizure (s) not attributable to pre-existing epileptic disease and / or a recent focal neurological symptom
* brain imaging suggestive of encephalitis, with EEG abnormalities suggestive of encephalitis

  * And absence of alternative diagnosis (intoxication, metabolic encephalopathy)
  * Persons affiliated or benefiting from a social security scheme;
  * Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research);
* Eligibility criteria for Acute Transverse Myelitis Patients:

  * Patient of at least 28 days of life
  * Acute onset of symptoms for more than 24 hours
  * Medullary focal abnormality, responsible for motor, sensory or autonomic symptoms
  * contrast enhancement on bone marrow MRI and / or abnormal CSF (≥ 5GB / mm3, protein uptake ≥ 0.40 g / L)
  * Evolution between nadir and maximum symptoms, less than 4 weeks
  * Persons affiliated or benefiting from a social security scheme;
  * Having given free, informed, written and signed consent by the patient or his legal representative (no later than the day of inclusion and prior to any review required by the research);

Exclusion Criteria:

* Primary vasculitis of the central nervous system or a documented specific impairment in an autoimmune condition
* Cerebral thrombophlebitis if not associated with encephalitis
* Meningitis without clinical or paraclinical argument for cerebral parenchymal involvement
* Pyogenic abscess
* Cerebral or spinal abscess
* Tumoral or hematological pathology of the central nervous system
* Toxic or metabolic encephalopathy
* Transverse myelitis with vascular or traumatic origin
* Known chronic infection with HTLV virus

Where it's running

• Centre Hospitalier Universitaire de la Guadeloupe
  Pointe-à-Pitre, Guadeloupe, Guadeloupe Recruiting

Study contacts

• Principal investigator: Hugo CHAUMONT, Doctor — CHU de la Guadeloupe
• Study coordinator: Val"érie HAMONY-SOTER
• Email: valerie.soter@chu-guadeloupe.fr
• Phone: +590 590 93 46 77

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.