Background. Purulent meningitis remains an important cause of mortality and morbidity among children worldwide. An immediate diagnosis of the causative microorganism is critical to significantly improving the outcome of this condition.

Case. In this study, we collected cerebrospinal fluid (CSF) samples from four patients clinically diagnosed with purulent meningitis. Patients with purulent meningitis may present with a variety of clinical symptoms or laboratory results. Infectious microorganisms including Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumonia, and Haemophilus influenzae were identified in the CSF samples via metagenomic nextgeneration sequencing (mNGS).

Conclusions. mNGS is effective for the immediate detection of pathogens, which can in turn facilitate prompt diagnosis and treatment among individuals with purulent meningitis, especially if conventional CSF results (such as CSF culture and polymerase chain reaction) are negative.

Keywords: case series, diagnosis, metagenomic next-generation sequencing, pediatrics, purulent meningitis