Coinfection of and detected in bronchoalveolar lavage fluid of a patient with pulmonary infection using metagenomic next-generation sequencing: A case report.

BACKGROUND

(), 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.

CASE DESCRIPTION

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 .

CONCLUSION

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.