二代基因测序诊断的第二例皮肤炭疽感染：病例报告。
The second cutaneous anthrax infection diagnosed by metagenomic next-generation sequencing: A case report.
机构信息
Department of Clinical Laboratory, The Third Hospital of Hebei Medical University, Hebei, China.
Hebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Hebei, China.
出版信息
Medicine (Baltimore). 2024 Jan 19;103(3):e36921. doi: 10.1097/MD.0000000000036921.
RATIONALE
Anthrax is a severe zoonotic infectious disease caused by Bacillus anthracis. Most reported cases were traditionally diagnosed through culture and microscopy. We reported here the second case of cutaneous anthrax diagnosed by metagenomic next-generation sequencing (mNGS).
PATIENT CONCERNS
A 63-year-old man had a history of contact with an unwell sheep, developing local redness and swelling on wrist. The dorsal side of the left hand and forearm, with tension blisters on the back of the left.
DIAGNOSIS
B anthracis was detected from culturing and mNGS of tension blisters.
INTERVENTIONS
On the second day of admission, the patient was administered 3.2 million units of penicillin every 6 hours, and isolated and closely observed.
OUTCOMES
The patient improves and is discharged.
LESSONS
Traditional bacterial cultures are time-consuming, while mNGS offers the advantage of accurate, quick, high-throughput, unbiased sequencing of all genetic material in a sample, which is a good technical tool for assisting in the diagnosis of rare pathogen infections.
背景
炭疽是一种由炭疽杆菌引起的严重人畜共患传染病。大多数报告的病例传统上通过培养和显微镜检查进行诊断。我们在此报告了第二例通过宏基因组下一代测序（mNGS）诊断的皮肤炭疽病例。
病例描述
一名 63 岁男性有接触病羊的病史，在手腕处出现局部红肿。左手和前臂的背部，左手背部有张力性水疱。
诊断
从张力性水疱的培养物和 mNGS 中检测到炭疽杆菌。
干预措施
入院第二天，患者每 6 小时接受 320 万单位青霉素治疗，并进行隔离和密切观察。
结果
患者病情好转并出院。
教训
传统的细菌培养耗时较长，而 mNGS 具有准确、快速、高通量、无偏测序样本中所有遗传物质的优势，是辅助诊断罕见病原体感染的良好技术工具。
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