Diagnosis of Histoplasma capsulatum pulmonary infection by tNGS: a case report

We report a case of a Chinese male patient with a history of riverside sampling work who presented with a cough and sputum production. Chest computed tomography revealed multiple lesions in both lungs, and bronchial examination indicated inflammatory changes. Histoplasmosis was identified through targeted next-generation sequencing (tNGS)detection of bronchoalveolar lavage fluid and diagnosed as Histoplasma capsulatum pneumonia. Lung biopsy and mNGS test further confirmed that the pathogen causing the pulmonary infection was Histoplasma capsulatum. Finally, the lesions were reduced and improved after three months of oral itraconazole and fluconazole (Diflucan) treatment. This case report highlights the advantages of tNGS technology, including rapid detection, broad coverage, high accuracy, and low cost. Therefore, tNGS can be a valuable supplement for diagnosing histoplasmosis and other pathogens.