A 56-year-old man receiving rituximab who had months of neurologic symptoms was found to have Jamestown Canyon virus in cerebrospinal fluid by clinical metagenomic sequencing. The patient died, and postmortem examination revealed extensive neuropathologic abnormalities. Deep sequencing enabled detailed characterization of viral genomes from the cerebrospinal fluid, cerebellum, and cerebral cortex.
Keywords: Jamestown Canyon virus; arbovirus; encephalitis; metagenomic next-generation sequencing; monoclonal antibody; orthobunyavirus; rituximab; vector-borne infections; viruses.