Case Report: Mycobacterium kansasii causing infective endocarditis explored by metagenomic next-generation sequencing

Area of Science:

• Infectious Diseases
• Genomics
• Cardiology

Background:

• Infective endocarditis is a serious infection of the heart lining.
• Mycobacterium kansasii is a rare cause of endocarditis, often presenting with non-specific symptoms.
• Traditional diagnostic methods like blood cultures can be negative in some cases.

Observation:

• A 45-year-old male with decompensated cirrhosis presented with fever and symptoms suggestive of endocarditis.
• Initial blood cultures and pathological examinations were negative for the causative agent.
• Metagenomic next-generation sequencing (mNGS) was utilized for comprehensive genomic analysis.

Findings:

• mNGS detected Mycobacterium kansasii sequences in the patient's peripheral blood, confirmed by Sanger sequencing.
• Copy number variation analysis from mNGS indicated a high risk of liver disease, correlating with clinical findings.
• Despite diagnosis, the patient's condition rapidly declined, leading to mortality before surgical intervention.

Implications:

• mNGS offers a promising alternative diagnostic tool for Mycobacterium kansasii endocarditis, especially when conventional methods are inconclusive.
• This case highlights the importance of considering M. kansasii in the differential diagnosis of endocarditis.
• Early and accurate diagnosis through advanced sequencing techniques can guide timely anti-infective treatment for rare pathogens.