Case Report: causing infective endocarditis explored by metagenomic next-generation sequencing.

In this report, we describe the first case of infective endocarditis caused by in a 45-year-old male patient who presented with a 10-day fever and decompensated cirrhosis. Despite negative results in blood culture and pathology, we employed metagenomic next-generation sequencing (mNGS) to analyze the genome sequences of both the host and microbe. The copy number variation (CNV) indicated a high risk of liver disease in the patient, which correlated with biochemical examination findings. Notably, sequences were detected in peripheral blood samples and confirmed through Sanger sequencing. Unfortunately, the patient's condition deteriorated, leading to his demise prior to heart surgery. Nevertheless, we propose that mNGS could be a novel approach for diagnosing infection, particularly in cases where blood culture and pathology results are unavailable. It is important to consider infection as a potential cause of endocarditis and initiate appropriate anti-infection treatment.