Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Genoxor Medical Science and Technology Inc., Shanghai, China.
J Infect Dev Ctries. 2024 Apr 30;18(4):651-654. doi: 10.3855/jidc.18114.
Mycobacterium marinum infection rarely occurs and has atypical symptoms. It is challenging to distinguish disseminated M. marinum infection from multifocal dermatosis caused by other factors clinically.
Herein, we reported a 68-year-old male patient with Human Immunodeficiency Virus (HIV) who presented redness and swelling in his left hand after being stabbed by marine fish for over 2 months. Mycobacterium tuberculosis infection was considered according to biochemical and pathological examinations, while empirical anti-infection treatment was ineffective.
The metagenomic next-generation sequencing (mNGS) detected a large amount of M. marinum sequences, and the patient was finally diagnosed with M. marinum infection. After one month of combination therapy with ethambutol, rifabutin, moxifloxacin, and linezolid, the swelling disappeared significantly. In this case, the successful application of mNGS in diagnosing and treating M. marinum infection has improved the understanding of the microbe both in the laboratory and clinically, especially in patients with HIV.
For diseases with atypical symptoms or difficulty in determining the pathogens, mNGS is suggested in clinical procedures for rapid and accurate diagnosis and treatment.
分枝杆菌感染很少见，且症状不典型。临床上很难将播散性分枝杆菌感染与由其他因素引起的多灶性皮肤病区分开来。
本研究报告了一例 68 岁男性 HIV 患者，他在被海洋鱼类刺伤后 2 个多月出现左手红肿。根据生化和病理检查，考虑分枝杆菌结核感染，而经验性抗感染治疗无效。
宏基因组下一代测序（mNGS）检测到大量分枝杆菌序列，最终诊断为分枝杆菌感染。经过一个月的乙胺丁醇、利福布汀、莫西沙星和利奈唑胺联合治疗后，肿胀明显消退。在该病例中，mNGS 在诊断和治疗分枝杆菌感染中的成功应用提高了对该微生物在实验室和临床方面的认识，特别是在 HIV 患者中。
对于症状不典型或难以确定病原体的疾病，建议在临床操作中使用 mNGS 进行快速准确的诊断和治疗。
