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病例报告:宏基因组学下一代测序在毛霉引起的颅内感染中的诊断价值

Case Report: Diagnostic Value of Metagenomics Next Generation Sequencing in Intracranial Infection Caused by Mucor.

作者信息

Liu YuChen, Zhang Jun, Han Bing, Du LiJuan, Shi ZhaoYang, Wang ChunCheng, Xu Min, Luo YongGang

机构信息

Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Med (Lausanne). 2021 Sep 23;8:682758. doi: 10.3389/fmed.2021.682758. eCollection 2021.

Abstract

mNGS(metagenomics Next Generation Sequencing), as a novel culture-independent approach, demonstrated the capability of rapid, sensitive, and accurate pathogen identification. At present, there have been many case reports about the use of mNGS to assist in the diagnosis of bacterial, fungal, viral and parasitic infections and to guide clinicians to determine appropriate treatment. However, the clinical understanding of this technique is not comprehensive, and the experience of using it is relatively limited. We reported a 53-year-old man who was admitted to hospital with a high fever and headache. His inflammatory biomarkers were markedly elevated. Based on the clinical presentation, He was initially diagnosed as having an intracranial infection of unknown etiology and received empirical antibiotics and systemic supportive treatment. But these did not relieve his symptoms. Both the blood and CSF specimens were examined using traditional culture, serological testing, and mNGS. Traditional culture and serological testing produced negative results, while the mNGS revealed the presence of a potential pathogen, , in the CSF specimen. Then targeted antifungal treatment was selected quickly and his temperature gradually returned to normal. Thus, we report the case in which mNGS was an auxiliary method to diagnose , and discuss this case in combination with relevant literature, in order to improve the clinical cognition of this technology.

摘要

宏基因组下一代测序(mNGS)作为一种新型的非培养方法,展现出快速、灵敏且准确的病原体鉴定能力。目前,已有许多关于使用mNGS辅助诊断细菌、真菌、病毒和寄生虫感染以及指导临床医生确定适当治疗方案的病例报告。然而,临床对该技术的了解并不全面,使用经验也相对有限。我们报告了一名53岁男性,因高热和头痛入院。他的炎症生物标志物显著升高。根据临床表现,他最初被诊断为病因不明的颅内感染,并接受了经验性抗生素治疗和全身支持治疗。但这些措施并未缓解他的症状。对血液和脑脊液标本进行了传统培养、血清学检测以及mNGS检测。传统培养和血清学检测结果均为阴性,而mNGS在脑脊液标本中发现了一种潜在病原体, 。随后迅速选择了针对性抗真菌治疗,他的体温逐渐恢复正常。因此,我们报告该mNGS辅助诊断 的病例,并结合相关文献对该病例进行讨论,以提高临床对该技术的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4607/8494775/e9dec2e33976/fmed-08-682758-g0001.jpg

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