Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report
Abstract Scedosporium boydii infections pose diagnostic challenges due to their nonspecific clinical manifestations and slow growth characteristics in conventional cultures. This paper highlights the diagnostic value of molecular technology combined with targeted prolonged culture for rare fungi. Un...
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BMC
2025-07-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11291-w |
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| author | Jiaqing Ye Suli Jin Yahua Li Weili Gao Cuiying Zheng Huifen Zuo Chenfeng Zhang Minghui Song Jiahao Hao Yuxin Liu Zhongjun Feng Hong Zhang Zhenjun Zhao Yumei Guo Lijie Zhang |
| author_facet | Jiaqing Ye Suli Jin Yahua Li Weili Gao Cuiying Zheng Huifen Zuo Chenfeng Zhang Minghui Song Jiahao Hao Yuxin Liu Zhongjun Feng Hong Zhang Zhenjun Zhao Yumei Guo Lijie Zhang |
| author_sort | Jiaqing Ye |
| collection | DOAJ |
| description | Abstract Scedosporium boydii infections pose diagnostic challenges due to their nonspecific clinical manifestations and slow growth characteristics in conventional cultures. This paper highlights the diagnostic value of molecular technology combined with targeted prolonged culture for rare fungi. Unitl now, only one case was identified using metagenomic next-generation sequencing (mNGS). This case represents the first report of a 20-day delayed culture confirmation of S. boydii guided by mNGS results in a non-immunocompromised chronic obstructive -with history of COPD who was admitted with fever and cough. Despite two weeks of antibacterial treatment, chest computed tomography (CT) showed worsening infection. To clarify the pathogen, mNGS and bacterial culture of bronchoalveolar lavage fluid (BALF) were performed. Subsequent culture and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) confirmed the growth of Scedosporium species. Based on clinical presentation, chest CT findings, mNGS results, pulmonary Scedosporiosis was diagnosed, and an antifungal treatment regimen (200 mg BID orally) was initiated. Subsequent culture confirmed S. boydii growth and antifungal susceptibility results were also obtained. After six weeks of voriconazole treatment, he was discharged from the hospital and continued to take oral medication for three months. He was fully recovered without recurrence after six months of follow-up. The present case suggests that mNGS findings can unveil cryptic pathogens like Scedosporium. Use mNGS results to trigger intentional, extended targeted cultivation– challenging standard incubation times– especially in non-immunocompromised hosts with underlying lung disease. Seamless clinician-laboratory collaboration is paramount for treatment success. |
| format | Article |
| id | doaj-art-0bfd154a12924ee88b6a2432cb73eb15 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-0bfd154a12924ee88b6a2432cb73eb152025-08-20T04:01:52ZengBMCBMC Infectious Diseases1471-23342025-07-012511710.1186/s12879-025-11291-wScedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case reportJiaqing Ye0Suli Jin1Yahua Li2Weili Gao3Cuiying Zheng4Huifen Zuo5Chenfeng Zhang6Minghui Song7Jiahao Hao8Yuxin Liu9Zhongjun Feng10Hong Zhang11Zhenjun Zhao12Yumei Guo13Lijie Zhang14Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical UniversityFirst Hospital of Hebei Medical UniversityHebei Medical University Third HospitalHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and PreventionHebei Medical University Third HospitalHebei Yiling HospitalHebei Medical University Third HospitalHebei Medical University Third HospitalHebei Medical University Third HospitalFourth Hospital of Hebei Medical UniversityHebei Medical University Third HospitalHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and PreventionHebei Yiling HospitalHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and PreventionHebei Medical University Third HospitalAbstract Scedosporium boydii infections pose diagnostic challenges due to their nonspecific clinical manifestations and slow growth characteristics in conventional cultures. This paper highlights the diagnostic value of molecular technology combined with targeted prolonged culture for rare fungi. Unitl now, only one case was identified using metagenomic next-generation sequencing (mNGS). This case represents the first report of a 20-day delayed culture confirmation of S. boydii guided by mNGS results in a non-immunocompromised chronic obstructive -with history of COPD who was admitted with fever and cough. Despite two weeks of antibacterial treatment, chest computed tomography (CT) showed worsening infection. To clarify the pathogen, mNGS and bacterial culture of bronchoalveolar lavage fluid (BALF) were performed. Subsequent culture and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) confirmed the growth of Scedosporium species. Based on clinical presentation, chest CT findings, mNGS results, pulmonary Scedosporiosis was diagnosed, and an antifungal treatment regimen (200 mg BID orally) was initiated. Subsequent culture confirmed S. boydii growth and antifungal susceptibility results were also obtained. After six weeks of voriconazole treatment, he was discharged from the hospital and continued to take oral medication for three months. He was fully recovered without recurrence after six months of follow-up. The present case suggests that mNGS findings can unveil cryptic pathogens like Scedosporium. Use mNGS results to trigger intentional, extended targeted cultivation– challenging standard incubation times– especially in non-immunocompromised hosts with underlying lung disease. Seamless clinician-laboratory collaboration is paramount for treatment success.https://doi.org/10.1186/s12879-025-11291-wMetagenomic Next-Generation sequencingPulmonary infectionScedosporium BoydiiCultureFungal infectionsChronic obstructive pulmonary disease |
| spellingShingle | Jiaqing Ye Suli Jin Yahua Li Weili Gao Cuiying Zheng Huifen Zuo Chenfeng Zhang Minghui Song Jiahao Hao Yuxin Liu Zhongjun Feng Hong Zhang Zhenjun Zhao Yumei Guo Lijie Zhang Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report BMC Infectious Diseases Metagenomic Next-Generation sequencing Pulmonary infection Scedosporium Boydii Culture Fungal infections Chronic obstructive pulmonary disease |
| title | Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report |
| title_full | Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report |
| title_fullStr | Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report |
| title_full_unstemmed | Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report |
| title_short | Scedosporium boydii pulmonary infection in an immunocompetent patient with COPD confirmed by next-generation metagenomic sequencing and culture: a case report |
| title_sort | scedosporium boydii pulmonary infection in an immunocompetent patient with copd confirmed by next generation metagenomic sequencing and culture a case report |
| topic | Metagenomic Next-Generation sequencing Pulmonary infection Scedosporium Boydii Culture Fungal infections Chronic obstructive pulmonary disease |
| url | https://doi.org/10.1186/s12879-025-11291-w |
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