Metagenomics test saves woman's sight after mystery infection
26 comments
·April 30, 2025dtech
nsagent
Good question. I started having digestive issues a year and a half ago. Went to various doctors and according to their lab tests was told everything was fine, that maybe this was my "new normal." Recently had an infection that necessitated broad spectrum antibiotics and magically my digestion issues have cleared up...
If not for getting sick recently I'd probably still be dealing with whatever gut infection I had that the doctors essentially ignored.
jchw
Sorry for your situation, or I suppose, glad to hear it's better. My understanding as a layperson is that antibiotics can be a nightmare for the gut: I don't think it's particularly likely, but you are a lot more likely to get C. diff while taking antibiotics, and I'm sure that's not the only way it can make things worse, alongside the other caveats of antibiotics (e.g. people misusing them in ways that threatens their effectiveness.) So, I can understand why doctors are not always eager to deploy antibiotics when they're not convinced they will help.
I've personally had quite some experiences navigating health issues, health anxiety, the medical system, etc. Nothing terribly interesting, but, still. I'm actually in middle of scheduling tests to see if I might, in fact, have an autoimmune condition. If they do find evidence of that, then it will have taken me around 6 years to figure it out from my very first symptoms. Thanks to modern medical science, I have little reason to sweat over it, though. (Of course, I'm still hoping for a negative, but at least in the case of a positive I can have the relief of knowing what the hell was wrong with me all this time.)
soulofmischief
Finding out I had gout was a 10 year process. Apparently "full test panels" don't include uric acid tests. And whenever symptoms are aggravated, it's much harder to test for it anyway as the crystals are lodged in your bones and not in your blood stream and urine.
Now I have to go through the entire process again to rule out everything else before getting a fibromyalgia diagnosis.
Anyway antibiotics have unrelatedly literally saved my life on several occasions now and I am glad that in a few emergencies I was able to access them on the street without needing to navigate the healthcare system. Antibiotics are too tightly controlled for humans and not enough for animals.
That said, I have had to take them enough that I've definitely experienced negative gut effects a couple of times. Now I reach for probiotics after a regimen.
Aurornis
> Recently had an infection that necessitated broad spectrum antibiotics and magically my digestion issues have cleared up...
There are non-absorbable antibiotics designed to target intestinal bacterial overgrowth. It’s hit or miss, though.
Unfortunately for many people, taking antibiotics can have the opposite effect where it creates or worsens gut problems. It’s not an easy or reliable solution.
TZubiri
Pretty sure antibiotics can make digestive problems worst as a side effect, so it's cool that it worked for you, but hindsight is 20 20
2Gkashmiri
My family has been testing various food items and it was found:
.dressed chicken .peanuts .soyabean oil .cumin
And we used to use these food "daily".
The allergy eruptions, digestive issues went from 100 to 5 starting next day.
This is such a small thing to check but it has saved us as a lot of trouble.
ajb
We don't actually know that they didn't try first-line antibiotics. My guess is that they did, and it's one of the things that didn't work. The UK is a bit cautious about causing antibiotic resistance, but my understanding is that that's more of an issue with long term use so may not be the determining factor here.
jghn
antibiotic resistance is such that it is increasingly less common to use it as just a "take 2 of these and call me in the morning" shot in the dark treatment.
like_any_other
If the symptoms are a sore throat, yes. If they're going blind, we can take a chance with antibiotics.
typingonmyphone
Had this been in the US, good chance would have received doxycycline as first line treatment and the leptospirosis identified by metagenomic sequencing would have resolved
ars
This surprised me also, till I realized the story was in the UK.
From my understanding it's much less common to get antibiotics in the UK vs US.
OJFord
There's concern of resistance taken seriously for sure, but it's not like people are making out here - I had fluclox prescribed after an online consultation in Jan (for probable cellulitis) - they don't give it out like candy, but when it's indicated...
Maybe they tried something broad spectrum here, and what was necessary (and required the sequencing to know what it actually was) was something more targeted.
tekla
> In 2019, while still at medical school, Ellie began suffering from inflammation in her right eye. All tests for infection came back negative and it was assumed she had an autoimmune condition.
You know how everyone complains about antibiotic resistance? Yeah, they're not going to give some random antibiotic if they have no idea what something might be.
londons_explore
Antibiotic resistance is a problem for society. Infection is a problem for the individual.
Modern medical ethics requires you always prioritise the individual over society, which means one should always give antibiotics if the benefits outweigh the downsides for this specific patient, even if that means you might cause antibiotic resistance for everyone else in the future.
tialaramex
If you know they've got an infection then I agree that's a problem and medical ethics would suggest treating it with antibiotics if available. But, they didn't know she had an infection.
You're assuming (and indeed US medicine seems to assume this everywhere) that since there don't usually seem to be major negative side effects from antibiotics they're harmless. However we are now confident they're not - lots of interesting things live inside us and whether or not they can cope with antibiotics varies, we're an ecosystem and so this intervention is a massive change to that ecosystem, and while it will usually be justifiable if we know there's an infection if we don't know that's now a gamble.
tekla
What is a society if not a collection of individuals?
You don't get to complain about antibiotic resistance if at the first sign of an issue you demand a bathing in random antibiotics, especially if you don't even know if you have a bacterial infection in the first place
BobbyTables2
Tell that to my urologists who put me through 4 courses of different antibiotics while 5 tests for infections were all negative…
bsder
Presumably the issue is that "went swimming in the Amazon" suddenly puts a ton of rare, difficult to identify diseases on the table.
Leptospirosis is known to be both prevalent in tropical areas and to be difficult to positively culture and identify.
raincom
Crux:
"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."
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aaron695
[dead]
What I find most interesting about this story that antibiotics weren't given when the patient had persistent inflammation and a clear cause couldn't be identified. It seems like such a common low risk treatment just to try. Especially curious why auto immune was assumed instead.