Yang Yan, Zhao Yingyue, Xi Xiaotong, Ding Ran, Yang Lei
Panzhihua Central Hospital, Sichuan Province, China.
State Key Laboratory of Neurology and Oncology Drug Development (Jiangsu Simcere Pharmaceutical Co., Ltd.), Jiangsu Simcere Diagnostics Co., Ltd., China.
Heliyon. 2024 Jun 15;10(12):e33130. doi: 10.1016/j.heliyon.2024.e33130. eCollection 2024 Jun 30.
(), as a potential human pathogen, has been reported in limited cases of human infections in medical literature. However, the increasing frequency of isolating from clinical specimens underscores its growing clinical significance that should not be underestimated. (), commonly isolated from various environments, serves as a pathogen of human cryptic aspergillosis. Clinical pathological changes caused by . are not obvious, posing a significant challenge in clinical diagnosis. Consequently, metagenomic next-generation sequencing (mNGS) are required for precise differentiation and identification of pathogens.
Here we present a case demonstrating successful treatment outcome in a patient with pulmonary infection caused by coinfection of and . , as identified through metagenomic next-generation sequencing. The patient, a 50-year-old male, presented with worsening cough, sputum production, and hemoptysis. Metagenomic next-generation sequencing (mNGS) analysis of the bronchoalveolar lavage fluid (BALF) revealed the presence of both and . . Subsequently, was also detected by culture in the same BALF sample, however while clinical fungal cultures and (1-3)-β-D glucan testing yielded negative results. Based on these findings along with imaging features and clinical symptoms of the patient, the final diagnosis was determined to be a co-infection of and .
The clinical manifestations of human infections caused by are not specific; patients with cryptic aspergillosis may have been previously overlooked due to improper specimen selection or negative routine tests. Therefore, precise identification of pathogens is crucial. This case report highlights the value of mNGS in detecting and in BALF, enabling timely diagnosis with coinfections.
（）作为一种潜在的人类病原体，在医学文献中关于人类感染的病例报道有限。然而，从临床标本中分离出该病原体的频率不断增加，凸显了其日益增长的临床重要性，不应被低估。（）通常从各种环境中分离出来，是人类隐匿性曲霉病的病原体。由（）引起的临床病理变化不明显，给临床诊断带来了重大挑战。因此，需要宏基因组下一代测序（mNGS）来精确区分和鉴定病原体。
在此，我们报告一例由（）和（）合并感染引起肺部感染的患者，经宏基因组下一代测序确诊，并成功治愈。该患者为50岁男性，表现为咳嗽、咳痰和咯血症状加重。对支气管肺泡灌洗液（BALF）进行宏基因组下一代测序（mNGS）分析，发现同时存在（）和（）。随后，在同一BALF样本中培养也检测到了（），而临床真菌培养和（1-3）-β-D葡聚糖检测结果均为阴性。根据这些发现以及患者的影像学特征和临床症状，最终诊断为（）和（）合并感染。
由（）引起的人类感染临床表现不具有特异性；隐匿性曲霉病患者可能因标本选择不当或常规检测结果阴性而被漏诊。因此，精确鉴定病原体至关重要。本病例报告强调了mNGS在检测BALF中（）和（）的价值，有助于及时诊断合并感染。
