Qin Weijuan, Guo Yuni, Liang Zhengyi, Wei Huanhuan, Huang Hongbo, Zhou Liyan, Tan Shaolin, Wu Xiaoning, Xie Li
Department of Clinical Laboratory, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
BMC Infect Dis. 2025 Sep 26;25(1):1155. doi: 10.1186/s12879-025-11451-y.
Cryptococcus neoformansis widely distributed in nature and primarily causes infections in various parts of the body through inhalation into the lungs. While C.neoformans infection predominantly occurs in immunocompromised individuals, there has been a significant increase in reports among immunocompetent hosts in recent years. Although the lungs and central nervous system constitute the most common sites of infection, cryptococcal osteomyelitis remains exceptionally rare and is typically associated with disseminated disease in immunodeficient patients. Herein, we present a rare case of isolated tibial cryptococcal osteomyelitis in an immunocompetent patient.
We report a case of a 64-year-old female who presented with pain, swelling, and increased local skin temperature in the left lower limb for one month without any obvious cause. The patient was initially diagnosed with osteomyelitis at a local county hospital and underwent surgical treatment. Due to poor postoperative healing, she was referred to our hospital for surgical debridement. Preoperative wound specimen culture revealed Luteimonas deserti. Simultaneously, intraoperative tissue samples were taken from the patient for targeted next-generation sequencing (tNGS) testing, which revealed the presence of C. neoformans. While the culture was negative, the C. neoformans capsular antigen test was positive. The patient had normal immune function and no underlying diseases. Ultimately, the patient was treated with fluconazole and surgery, resulting in a good prognosis.
we report a case of tibial osteomyelitis caused by Cryptococcus neoformans in an immunocompetent patient, with diagnosis confirmed through targeted next-generation sequencing (tNGS) and serum Cryptococcal capsular antigen testingOur results demonstrate the great potential of tNGS in the detection of infectious pathogens. In patients with negative culture results, tNGS can quickly detect various pathogens, providing accurate diagnosis and facilitating appropriate treatment for patients.
新型隐球菌广泛分布于自然界，主要通过吸入肺部而导致身体各部位感染。虽然新型隐球菌感染主要发生在免疫功能低下的个体中，但近年来免疫功能正常宿主中的报告显著增加。尽管肺部和中枢神经系统是最常见的感染部位，但隐球菌性骨髓炎仍然极为罕见，通常与免疫缺陷患者的播散性疾病相关。在此，我们报告一例免疫功能正常患者孤立性胫骨隐球菌性骨髓炎的罕见病例。
我们报告一例64岁女性，她无明显原因出现左下肢疼痛、肿胀及局部皮肤温度升高1个月。患者最初在当地县医院被诊断为骨髓炎并接受了手术治疗。由于术后愈合不佳，她被转诊至我院进行手术清创。术前伤口标本培养显示为沙漠栖黄单胞菌。同时，术中从患者身上采集组织样本进行靶向二代测序（tNGS）检测，结果显示存在新型隐球菌。虽然培养结果为阴性，但新型隐球菌荚膜抗原检测呈阳性。患者免疫功能正常且无基础疾病。最终，患者接受氟康唑治疗及手术，预后良好。
我们报告一例免疫功能正常患者由新型隐球菌引起的胫骨骨髓炎病例，通过靶向二代测序（tNGS）和血清隐球菌荚膜抗原检测确诊。我们的结果表明tNGS在检测感染性病原体方面具有巨大潜力。在培养结果为阴性的患者中，tNGS可快速检测出各种病原体，为患者提供准确诊断并便于进行恰当治疗。
