Chen Hengxin, Qiu Mingjin, Xu Hongxu, Guo Penghao, Peng Yaqin
Department of Clinical Laboratory, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, People's Republic of China.
Department of Clinical Laboratory, Nansha Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 511455, People's Republic of China.
Infect Drug Resist. 2024 Dec 19;17:5707-5713. doi: 10.2147/IDR.S499419. eCollection 2024.
is one of the major pathogens in mucormycosis. Infection due to is rare and has a high mortality rate, especially disseminated mucormycosis infections. Rapid and accurate pathogen identification is important for the development of targeted antifungal therapies.
We presented a case of disseminated infection, identified through metagenomics next-generation sequencing (mNGS), in a 4-year-old patient with acute lymphoblastic leukemia. On days 22, 23, and 28, was detected in bronchoalveolar lavage fluid, blood, and hydrothorax, respectively, through mNGS. The patient developed lung, pleural, and blood disseminated lesions caused by infection. Subsequently, the patient was treated with antifungal therapy, including posaconazole, amphotericin B, and isacconazole, with supportive treatment. However, with the continuous deterioration of symptoms, the patient's family decided to give up treatment. The patient eventually died of multiple-organ failure on day 34.
mNGS facilitates prompt diagnosis of disseminated infections. The successful application of mNGS provided a new perspective for the clinician, underscoring the technique's potential for rapid diagnostic etiology. mNGS has the capability to identify pathogens at the species level, which is a significant asset in guiding clinical medication decisions.
是毛霉病的主要病原体之一。由引起的感染罕见且死亡率高，尤其是播散性毛霉病感染。快速准确的病原体鉴定对于制定针对性抗真菌治疗方案很重要。
我们报告了一例通过宏基因组学下一代测序（mNGS）确诊的播散性感染病例，患者为一名4岁急性淋巴细胞白血病患儿。在第22天、23天和28天，分别通过mNGS在支气管肺泡灌洗液、血液和胸腔积液中检测到。患者出现了由感染引起的肺部、胸膜和血液播散性病变。随后，患者接受了包括泊沙康唑、两性霉素B和艾沙康唑在内的抗真菌治疗及支持治疗。然而，随着症状持续恶化，患者家属决定放弃治疗。患者最终在第34天死于多器官功能衰竭。
mNGS有助于快速诊断播散性感染。mNGS的成功应用为临床医生提供了新视角，凸显了该技术在快速诊断病因方面的潜力。mNGS有能力在物种水平鉴定病原体，这在指导临床用药决策方面是一项重要优势。
