Li Qiujing, Li Mingwu, Wang Shuxian, Geater Alan F, Dai Jingyi
Department of Public Laboratory, The Third People's Hospital of Kunming City, Infectious Disease Clinical Medical Center of Yunnan Province, Kunming, Yunnan, People's Republic of China.
Department of Tuberculosis, The Third People's Hospital of Kunming City, Infectious Disease Clinical Medical Center of Yunnan Province, Kunming, Yunnan, People's Republic of China.
Infect Drug Resist. 2024 Aug 29;17:3751-3757. doi: 10.2147/IDR.S471938. eCollection 2024.
This case reports a middle-aged male patient who was HIV-negative and initially misdiagnosed as pulmonary tuberculosis but was eventually diagnosed with disseminated infection by next-generation sequencing. The patient presented with respiratory symptoms, recurrent bone pain, and subcutaneous masses as the main symptoms. After one year of antifungal treatment, the symptoms improved obviously, but the symptoms recurred after two weeks of drug withdrawal, and the symptoms were relieved after re-administration of antifungal drugs again. This report highlights the need for the rapid evaluation of fungal infections with metagenomic next-generation sequencing (mNGS) in patients with an inadequate diagnostic basis for tuberculosis infection or a poor response to antituberculosis drugs. In addition, long-term follow-up is needed to observe disease recurrence in patients with disseminated infection.
本病例报告了一名中年男性患者，其HIV检测呈阴性，最初被误诊为肺结核，但最终通过下一代测序被诊断为播散性感染。患者以呼吸道症状、反复骨痛和皮下肿块为主要症状。经过一年的抗真菌治疗，症状明显改善，但停药两周后症状复发，再次使用抗真菌药物后症状缓解。本报告强调，对于肺结核感染诊断依据不足或对抗结核药物反应不佳的患者，需要用宏基因组下一代测序（mNGS）快速评估真菌感染。此外，对于播散性感染患者，需要进行长期随访以观察疾病复发情况。
