Parkinson's disease, herpes simplex virus type 1, and nanopore sequencing: A case analysis

Parkinson's disease (PD) is a chronic neurodegenerative disorder that impacts the central nervous system, primarily the motor nervous system. Patients frequently experience respiratory muscle dysfunction, which can lead to swallowing disorders, coughing, ultimately inducing aspiration pneumonia. PD patients in the intensive care unit (ICU) are at risk of being infected with drug-resistant pathogens. This case report presents a PD patient with aspiration pneumonia. As the patient did not show improvement after empirical treatments such as antibiotics, nanopore targeted sequencing (NTS) was employed to detect pathogens in bronchoalveolar lavage fluid in real time, enabling timely detection of HSV-1 infection and adjustment of the treatment strategy. Additionally, whole-exome sequencing (WES) was utilized to explore the genetic background of the patient and identify key mutation genes related to both PD and HSV-1. An attempt was made to explore the drug selection and mechanism connection between the two diseases from the perspectives of protein structure changes and lactylation modification, with the hope of providing new clues for precision medicine. Moreover, it was found that Glasgow Coma Scale (GCS) scores and neutrophils were related to pneumonia pathogen detection results. It is speculated that NTS can not only detect pathogen infection but also evaluate the treatment effect of pneumonia. Overall, this study proposed a novel method for the diagnosis and treatment of PD complicated by aspiration pneumonia by combining clinical indicators and genetic analysis, providing a new idea for the dynamic monitoring and precise treatment of PD, a disease with complex pathogenesis and complications.