Application of metagenomic next-generation sequencing in cutaneous tuberculosis

Area of Science:

• Infectious Diseases
• Dermatology
• Microbiology

Background:

• Cutaneous tuberculosis (TB) is an uncommon manifestation of Mycobacterium tuberculosis complex (MTBC) infection.
• Diagnosis can be challenging, especially in pediatric cases presenting solely with a wound.
• Early and accurate identification of the causative pathogen is crucial for effective treatment.

Purpose of the Study:

• To report a case of pediatric cutaneous tuberculosis presenting as a persistent wound infection.
• To highlight the utility of metagenomic next-generation sequencing (mNGS) in diagnosing rare infectious diseases.
• To emphasize the importance of considering extrapulmonary TB in challenging wound cases.

Main Methods:

• Clinical case presentation of a child with a non-healing wrist wound.
• Initial surgical debridement and standard laboratory investigations.
• Metagenomic next-generation sequencing (mNGS) of wound secretions for pathogen identification.

Main Results:

• Standard laboratory tests were unremarkable.
• mNGS of wound secretions detected three reads belonging to the Mycobacterium tuberculosis complex (MTBC).
• Diagnosis of cutaneous tuberculosis was confirmed, and the wound resolved following anti-TB drug administration.

Conclusions:

• Cutaneous tuberculosis should be considered in the differential diagnosis of non-healing, swollen, and painful wounds, particularly in children.
• mNGS is a valuable tool for identifying pathogens in complex or rare infectious conditions, facilitating timely treatment.
• Prompt diagnosis and targeted therapy for extrapulmonary MTBC infections significantly improve patient outcomes.