Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report
Abstract Background Polymicrobial pulmonary infections, common in immunocompromised patients, often manifest more severe symptoms than monomicrobial infections. Clinical diagnosis delays may lead to mortality, emphasizing the importance of fast and accurate diagnosis for these patients. Metagenomic...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12890-024-03473-0 |
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| author | Jing Duan Jie Ding Yupeng Wei Yingxin Zhang Zhiqing You Ding Li Chao Chen |
| author_facet | Jing Duan Jie Ding Yupeng Wei Yingxin Zhang Zhiqing You Ding Li Chao Chen |
| author_sort | Jing Duan |
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| description | Abstract Background Polymicrobial pulmonary infections, common in immunocompromised patients, often manifest more severe symptoms than monomicrobial infections. Clinical diagnosis delays may lead to mortality, emphasizing the importance of fast and accurate diagnosis for these patients. Metagenomic next-generation sequencing (mNGS), as an unbiased method capable of detecting all microbes, is a valuable tool to identify pathogens, particularly in cases where infections are difficult to diagnosis using conventional methods. Case presentation A 50-year-old male patient was admitted due to cough, expectoration and dyspnea. CT scan revealed diffuse inflammatory and cavernous lung lesion, and blood examination suggested a polymicrobial infection. However, no etiology was found by routine examination. mNGS of bronchoalveolar lavage fluid(BALF)simultaneously detected the presence of Pneumocystis jirovecii (P.jirovecii), Aspergillus fumigates (A.fumigates), Nocardia farcinica (N.farcinica), Salmonella enterica subsp. enterica (S.enterica subsp. enterica), and cytomegalovirus (CMV). The patient was successfully treated with compound sulfamethoxazole (SMZ-TMP), cefoperazone/sulbactam (SCF), moxifloxacin (MXF), voriconazole (VCZ), and ganciclovir. The patient recovered after two weeks of anti-infection therapy and maintained good health at a six-month follow-up. Conclusion For immunocompromised patients with multiple infections and atypical symptoms, mNGS emerged as a reliable approach to pathogen detection and guiding antibiotic therapy. |
| format | Article |
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| institution | Kabale University |
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| language | English |
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| series | BMC Pulmonary Medicine |
| spelling | doaj-art-33de03d1671b4ce68b5883f9f5bd82522025-01-12T12:06:38ZengBMCBMC Pulmonary Medicine1471-24662025-01-012511610.1186/s12890-024-03473-0Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case reportJing Duan0Jie Ding1Yupeng Wei2Yingxin Zhang3Zhiqing You4Ding Li5Chao Chen6Department of Clinical Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityCentral Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityInstitute of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical ScienceCentral Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityDepartment of Clinical Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityDepartment of Clinical Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityCentral Laboratory, Liaocheng People’s Hospital and Liaocheng School of Clinical Medicine, Shandong First Medical UniversityAbstract Background Polymicrobial pulmonary infections, common in immunocompromised patients, often manifest more severe symptoms than monomicrobial infections. Clinical diagnosis delays may lead to mortality, emphasizing the importance of fast and accurate diagnosis for these patients. Metagenomic next-generation sequencing (mNGS), as an unbiased method capable of detecting all microbes, is a valuable tool to identify pathogens, particularly in cases where infections are difficult to diagnosis using conventional methods. Case presentation A 50-year-old male patient was admitted due to cough, expectoration and dyspnea. CT scan revealed diffuse inflammatory and cavernous lung lesion, and blood examination suggested a polymicrobial infection. However, no etiology was found by routine examination. mNGS of bronchoalveolar lavage fluid(BALF)simultaneously detected the presence of Pneumocystis jirovecii (P.jirovecii), Aspergillus fumigates (A.fumigates), Nocardia farcinica (N.farcinica), Salmonella enterica subsp. enterica (S.enterica subsp. enterica), and cytomegalovirus (CMV). The patient was successfully treated with compound sulfamethoxazole (SMZ-TMP), cefoperazone/sulbactam (SCF), moxifloxacin (MXF), voriconazole (VCZ), and ganciclovir. The patient recovered after two weeks of anti-infection therapy and maintained good health at a six-month follow-up. Conclusion For immunocompromised patients with multiple infections and atypical symptoms, mNGS emerged as a reliable approach to pathogen detection and guiding antibiotic therapy.https://doi.org/10.1186/s12890-024-03473-0Metagenomic next-generation sequencingPolymicrobial infectionImmunocompromised patientCase report |
| spellingShingle | Jing Duan Jie Ding Yupeng Wei Yingxin Zhang Zhiqing You Ding Li Chao Chen Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report BMC Pulmonary Medicine Metagenomic next-generation sequencing Polymicrobial infection Immunocompromised patient Case report |
| title | Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report |
| title_full | Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report |
| title_fullStr | Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report |
| title_full_unstemmed | Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report |
| title_short | Metagenomic analysis identifying a polymicrobial pulmonary infection in a non-HIV immunocompromised patient: a case report |
| title_sort | metagenomic analysis identifying a polymicrobial pulmonary infection in a non hiv immunocompromised patient a case report |
| topic | Metagenomic next-generation sequencing Polymicrobial infection Immunocompromised patient Case report |
| url | https://doi.org/10.1186/s12890-024-03473-0 |
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