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Metagenomic next-generation sequencing (mNGS) identified Clostridium perfringens infection presenting as acute
Shifang Yu1, Tinghui Cao1, Zhijiang Xu1
1Department of Transfusion Medicine, Laboratory Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Zhejiang, PR China.
Abstract:
Clostridium perfringens (C. perfringens) septicaemia is a rare, but rapidly fatal infection, characterized by massive hemolysis. In numerous documented instances, the patient was not diagnosed in time due to the absence of typical clinical features. In order to enhance diagnostic accuracy, metagenomic next-generation sequencing (mNGS) has been adopted as a novel approach to pathogen identification. CASE PRESENTATION: A 67-year-old male who had undergone transcatheter arterial chemoembolization (TACE) surgery four days earlier presented with severe anemia, and laboratory investigations disclosed intravascular hemolysis. Swift and accurate identification was imperative, resulting in the confirmation of mNGS analysis, his medical history, clinical symptoms, physical signs, additional tests, and C. perfringens as the causative pathogen of hemolysis. After successful treatment with effective antibiotics, the patient recovered and was discharged from the hospital after 19 days. CONCLUSIONS: mNGS achieves expedited diagnostic turnaround time through rapid pathogen identification, significantly surpassing conventional culture methods. This may enable the diagnosis of atypical cases of C. perfringens infection, which can cause rapid systemic shock, renal failure, intravascular hemolysis, and even death.
Insights
Metagenomic next-generation sequencing (mNGS) rapidly identified Clostridium perfringens causing hemolysis in a patient with atypical symptoms. This advanced technique improves diagnosis of rare, fatal infections.
Area of Science:
- Infectious Diseases
- Genomics
- Medical Diagnostics
Background:
- Clostridium perfringens septicaemia is a rare but fatal infection often missed due to atypical clinical presentations.
- Massive hemolysis is a key characteristic of C. perfringens septicaemia.
- Metagenomic next-generation sequencing (mNGS) offers a novel approach for pathogen identification to improve diagnostic accuracy.
Purpose of the Study:
- To evaluate the utility of mNGS in diagnosing a case of C. perfringens septicaemia presenting with intravascular hemolysis.
- To highlight the diagnostic advantages of mNGS over conventional methods in critical infections.
Main Methods:
- A 67-year-old male patient presented with severe anemia and intravascular hemolysis four days post-transcatheter arterial chemoembolization (TACE).
- Metagenomic next-generation sequencing (mNGS) was employed for rapid pathogen identification.
- Clinical data, medical history, and laboratory findings were analyzed in conjunction with mNGS results.
Main Results:
- mNGS successfully identified Clostridium perfringens as the causative agent of hemolysis.
- The patient received effective antibiotic treatment and recovered, being discharged after 19 days.
- mNGS demonstrated a significantly faster diagnostic turnaround time compared to traditional culture methods.
Conclusions:
- mNGS facilitates expedited diagnosis of C. perfringens infections, surpassing conventional methods.
- This technology can aid in identifying atypical cases of C. perfringens, preventing severe outcomes like shock, renal failure, and death.
- Rapid pathogen identification via mNGS is crucial for timely and effective treatment of life-threatening infections.
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