Zou Zhuo-Lin, Shen Zhong-Hai
Department of Infectious Diseases, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing 314000, China.
Institute of Hepatology, Affiliated Hospital of Jiaxing University, Jiaxing 314000, China.
IDCases. 2025 Jun 6;41:e02279. doi: 10.1016/j.idcr.2025.e02279. eCollection 2025.
We present a complex case of a 43-year-old HIV-positive Chinese male with co-infection of amoebic liver abscess (ALA) and bacterial liver abscess caused by subsp. serotype Typhi (abbreviated as Typhi). The patient presented with fever and abdominal pain. Initial bacterial cultures identified Typhi, but targeted antibiotic therapy failed to resolve his symptoms, prompting to further investigation. Metagenomic next-generation sequencing (mNGS) of pleural and liver abscess drainage fluids revealed sequences of , confirming a dual infection. The patient was treated with combination therapy, resulting in clinical improvement. This case highlights diagnostic challenges in immunocompromised patients and underscores the critical role of mNGS in identifying co-infections and guiding treatment. Early recognition and timely intervention are essential for achieving optimal outcomes in such complex cases.
我们报告了一例复杂病例，患者为一名43岁的HIV阳性中国男性，同时感染了阿米巴肝脓肿（ALA）和由伤寒亚种血清型Typhi（简称为Typhi）引起的细菌性肝脓肿。患者出现发热和腹痛症状。初始细菌培养鉴定出Typhi，但针对性的抗生素治疗未能缓解其症状，促使进一步检查。对胸腔和肝脓肿引流液进行宏基因组下一代测序（mNGS），发现了[具体病原体名称未给出]的序列，证实为双重感染。患者接受联合治疗后临床症状改善。该病例凸显了免疫受损患者的诊断挑战，并强调了mNGS在识别合并感染和指导治疗方面的关键作用。对于此类复杂病例，早期识别和及时干预对于实现最佳治疗效果至关重要。
