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病例报告:一名血液系统恶性肿瘤患者确诊为培养阴性的慢性播散性念珠菌病:宏基因组二代测序(mNGS)与荧光白(CFW)染色的联合应用

Case Report: Proven Diagnosis of Culture-Negative Chronic Disseminated Candidiasis in a Patient Suffering From Hematological Malignancy: Combined Application of mNGS and CFW Staining.

作者信息

Jin Yanqi, Wang Zhouhan, Zhu Chunxia, Yang Qing, Lu Yingfeng, Yu Xiaopeng, Hong Bao, Wang Xiaojing, Zhang Yimin

机构信息

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Laboratory Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Front Med (Lausanne). 2021 Feb 24;8:627166. doi: 10.3389/fmed.2021.627166. eCollection 2021.

Abstract

Chronic disseminated candidiasis (CDC) is a severe complication with high morbidity and mortality in patients with hematological malignancies who have undergone chemotherapy. Blood or sterile liver biopsy cultures are negative due to recurrent empirical antifungal therapy. With the escalating resistance to azole-based antifungal drugs in infection by species, pathogen identification is becoming increasingly important for determining definitive diagnosis and treatment strategy. In this case report, we present, for the first time, diagnostic confirmation of a culture-negative CDC case with infection using a combination of metagenomics next-generation sequencing and calcofluor white staining.

摘要

慢性播散性念珠菌病(CDC)是接受化疗的血液系统恶性肿瘤患者中一种严重的并发症,发病率和死亡率很高。由于反复进行经验性抗真菌治疗,血液或无菌肝活检培养结果均为阴性。随着念珠菌属感染对唑类抗真菌药物的耐药性不断增加,病原体鉴定对于确定明确诊断和治疗策略变得越来越重要。在本病例报告中,我们首次使用宏基因组学下一代测序和荧光增白剂染色相结合的方法,对一例由念珠菌属感染引起的培养阴性的CDC病例进行了诊断确认。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/502a/7943471/78e471879705/fmed-08-627166-g0001.jpg

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