Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China.
J Microbiol Immunol Infect. 2023 Dec;56(6):1284-1287. doi: 10.1016/j.jmii.2023.07.001. Epub 2023 Jul 18.
Helicobacter cinaedi is known to cause various infections in immunocompromised hosts ranging from skin lesions to disseminated septicemia. Identification of H. cinaedi is difficult through conventional identification methods due to its fastidious nature. We reported a refractory and culture-negative pyoderma gangrenosum-like ulcer caused by H. cinaedi in a patient with primary agammaglobulinemia. Metagenomic next-generation sequencing (mNGS) was applied for the identification of H. cinaedi and prolonged minocycline and amoxicillin-clavulanate potassium was used to eradicate the infection. Given the difficulties in culturing this organism, it's highly possible that H cinaedi infections have been overlooked. We suggest that early consideration of H. cinaedi infection should be suspected in immunocompromised patients presenting with unexplained skin lesions as the appropriate antibiotic choice plus a prolonged treatment course is essential for the prognosis. Application of mNGS could contribute to the early identification of rare and cryptogenic pathogens.
脆弱拟杆菌会导致免疫功能低下的宿主发生各种感染，从皮肤损伤到全身败血症。由于其生长条件苛刻，传统的鉴定方法很难鉴定出脆弱拟杆菌。我们报告了一例原发性无丙种球蛋白血症患者发生难治性、培养阴性坏疽性脓皮病样溃疡，由脆弱拟杆菌引起。采用宏基因组下一代测序（mNGS）鉴定脆弱拟杆菌，并使用米诺环素和阿莫西林克拉维酸钾延长疗程以消除感染。鉴于培养这种微生物的困难，很可能已经忽略了脆弱拟杆菌感染。我们建议，免疫功能低下的患者出现不明原因的皮肤损伤时，应高度怀疑存在脆弱拟杆菌感染，因为适当的抗生素选择和延长疗程对预后至关重要。mNGS 的应用有助于早期发现罕见和隐匿性病原体。
