Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome
To our knowledge, this is the first reported case of a pulmonary mixed infection involving Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus (HCMV) in a patient with minimal change nephrotic syndrome (MCNS), which is of great clinical significance. We report the case...
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Frontiers Media S.A.
2025-05-01
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| author | Yahua Li Jiaqing Ye Chenfeng Zhang Weili Gao Hong Zhang Cuiying Zheng Zhongjun Feng Minghui Song Jiahao Hao Huifen Zuo Zhenjun Zhao Yumei Guo Lijie Zhang |
| author_facet | Yahua Li Jiaqing Ye Chenfeng Zhang Weili Gao Hong Zhang Cuiying Zheng Zhongjun Feng Minghui Song Jiahao Hao Huifen Zuo Zhenjun Zhao Yumei Guo Lijie Zhang |
| author_sort | Yahua Li |
| collection | DOAJ |
| description | To our knowledge, this is the first reported case of a pulmonary mixed infection involving Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus (HCMV) in a patient with minimal change nephrotic syndrome (MCNS), which is of great clinical significance. We report the case of an 18-year-old male with a two-month history of MCNS who was admitted due to fever, cough, and bright red hemoptysis. Upon admission, he was treated with piperacillin/tazobactam and moxifloxacin for one week; however, the therapeutic response was suboptimal. Metagenomic Next-Generation Sequencing (mNGS) and microbiological culture of bronchoalveolar lavage fluid identified a pulmonary mixed infection involving N. cyriacigeorgica, S. maltophilia, and HCMV. Following the initiation of combination therapy with linezolid, trimethoprim-sulfamethoxazole, and ganciclovir, the patient’s condition improved markedly, and he was discharged in a stable condition. One-year follow-up revealed complete recovery with no recurrence. This case highlights the critical role of incorporating advanced molecular diagnostic tools such as mNGS into clinical practice and the need to be vigilance about opportunistic infections involving multiple pathogens, especially in patients receiving immunosuppressive therapy. |
| format | Article |
| id | doaj-art-8b7053d7bef94a6f942afdacab27262d |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-8b7053d7bef94a6f942afdacab27262d2025-08-20T03:08:26ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15999581599958Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndromeYahua Li0Jiaqing Ye1Chenfeng Zhang2Weili Gao3Hong Zhang4Cuiying Zheng5Zhongjun Feng6Minghui Song7Jiahao Hao8Huifen Zuo9Zhenjun Zhao10Yumei Guo11Lijie Zhang12Department of Respiratory and Critical Care Medicine, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuan, ChinaHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuan, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaLaboratory Department, Hebei Yiling Hospital, Shijiazhuan, ChinaLaboratory Department, Hebei Yiling Hospital, Shijiazhuan, ChinaHebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuan, ChinaLaboratory Department, Hebei Medical University Third Hospital, Shijiazhuang, ChinaTo our knowledge, this is the first reported case of a pulmonary mixed infection involving Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus (HCMV) in a patient with minimal change nephrotic syndrome (MCNS), which is of great clinical significance. We report the case of an 18-year-old male with a two-month history of MCNS who was admitted due to fever, cough, and bright red hemoptysis. Upon admission, he was treated with piperacillin/tazobactam and moxifloxacin for one week; however, the therapeutic response was suboptimal. Metagenomic Next-Generation Sequencing (mNGS) and microbiological culture of bronchoalveolar lavage fluid identified a pulmonary mixed infection involving N. cyriacigeorgica, S. maltophilia, and HCMV. Following the initiation of combination therapy with linezolid, trimethoprim-sulfamethoxazole, and ganciclovir, the patient’s condition improved markedly, and he was discharged in a stable condition. One-year follow-up revealed complete recovery with no recurrence. This case highlights the critical role of incorporating advanced molecular diagnostic tools such as mNGS into clinical practice and the need to be vigilance about opportunistic infections involving multiple pathogens, especially in patients receiving immunosuppressive therapy.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1599958/fullmetagenomic next-generation sequencingpulmonary infectionNocardia cyriacigeorgicaStenotrophomonas maltophiliahuman cytomegalovirusminimal change nephrotic syndrome |
| spellingShingle | Yahua Li Jiaqing Ye Chenfeng Zhang Weili Gao Hong Zhang Cuiying Zheng Zhongjun Feng Minghui Song Jiahao Hao Huifen Zuo Zhenjun Zhao Yumei Guo Lijie Zhang Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome Frontiers in Immunology metagenomic next-generation sequencing pulmonary infection Nocardia cyriacigeorgica Stenotrophomonas maltophilia human cytomegalovirus minimal change nephrotic syndrome |
| title | Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| title_full | Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| title_fullStr | Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| title_full_unstemmed | Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| title_short | Case Report: Pulmonary mixed infection by Nocardia cyriacigeorgica, Stenotrophomonas maltophilia, and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| title_sort | case report pulmonary mixed infection by nocardia cyriacigeorgica stenotrophomonas maltophilia and human cytomegalovirus in a patient with minimal change nephrotic syndrome |
| topic | metagenomic next-generation sequencing pulmonary infection Nocardia cyriacigeorgica Stenotrophomonas maltophilia human cytomegalovirus minimal change nephrotic syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1599958/full |
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