Zhang Wei, Xiao Li, Shan Xingxing, Dai Bing, Tang Chunyan, Xian Jianchun, Yu Yan
Changsha KingMed Diagnostics Group Co., Ltd., Changsha, Hunan, China.
Department of Infection and Hepatology, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou, China.
Front Med (Lausanne). 2024 Nov 19;11:1483027. doi: 10.3389/fmed.2024.1483027. eCollection 2024.
INTRODUCTION/BACKGROUND: is the causative agent of the human intestinal infectious disease cholera, which includes a variety of serogroups. However, there have been very few cases of hepatic space-occupying lesions associated with this infection. Currently, there are various methods for detecting this pathogen, including metagenomic sequencing, which enables quicker and more accurate identification. In this study, metagenomic sequencing is employed to accurately identify non-O1/O139 infections by analyzing the genetic material present in clinical samples.
A 75-year-old man presented with diarrhea and fever after consuming crabs. The initial treatment improved the diarrhea, but a liver abscess developed later. Magnetic resonance imaging (MRI) of the liver revealed a hepatic space-occupying lesion. Upon further investigation, a Gram-negative, rod-shaped bacterium was cultured from the patient's liver puncture fluid, and was detected in the same fluid using metagenomic next-generation sequencing (mNGS). The pathogen was confirmed to be non-O1/non-O139 () using polymerase chain reaction (PCR). Following treatment with piperacillin/tazobactam sodium and moxifloxacin, the patient's body temperature returned to normal, the liver abscess improved significantly, and he was subsequently discharged from the hospital.
This case study describes an elderly male patient with a hepatic space-occupying lesion. Multiple cultures of specimens failed to identify the underlying cause; however, advanced techniques such as mNGS and PCR confirmed an infection. This indicates that mNGS can serve as a valuable tool in diagnosing cases of unexplained liver infections.
The use of mNGS is significant for detecting and clinically diagnosing infectious pathogens in patients with unexplained space-occupying lesions.
引言/背景：霍乱弧菌是人类肠道传染病霍乱的病原体，包括多种血清群。然而，与这种感染相关的肝占位性病变病例非常少。目前，检测这种病原体有多种方法，包括宏基因组测序，它能实现更快、更准确的鉴定。在本研究中，通过分析临床样本中的遗传物质，采用宏基因组测序来准确鉴定非O1/O139霍乱弧菌感染。
一名75岁男性在食用螃蟹后出现腹泻和发热。初始治疗改善了腹泻，但后来出现了肝脓肿。肝脏磁共振成像（MRI）显示有肝占位性病变。进一步检查发现，从患者肝穿刺液中培养出一种革兰氏阴性杆菌，使用宏基因组下一代测序（mNGS）在同一液体中检测到霍乱弧菌。使用聚合酶链反应（PCR）确认病原体为非O1/非O139霍乱弧菌。经哌拉西林/他唑巴坦钠和莫西沙星治疗后，患者体温恢复正常，肝脓肿明显改善，随后出院。
本病例研究描述了一名患有肝占位性病变的老年男性患者。对标本进行多次培养未能确定根本原因；然而，mNGS和PCR等先进技术证实了霍乱弧菌感染。这表明mNGS可作为诊断不明原因肝脏感染病例的有价值工具。
mNGS的应用对于检测和临床诊断不明原因占位性病变患者的感染病原体具有重要意义。
