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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Main Authors: 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
Format: Article
Language:English
Published: BMC 2025-07-01
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
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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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