Metagenomic next-generation sequencing reveals the clinicopathological features of mucormycosis

Mucormycosis is a rare but highly lethal opportunistic infection driven by mucor fungi, which mainly affects individuals with compromised immune systems, such as diabetic patients and organ transplant recipients. This study aims to investigate the clinicopathological features of patients with mucormycosis diagnosed by metagenomic next-generation sequencing (mNGS).

A systematic analysis was conducted in 15 cases of mucormycosis diagnosed and treated at Hunan Provincial People's Hospital between January 2019 and July 2024. Various detection methods were utilized, including hematoxylin-eosin staining, fungal fluorescence staining, fungal culture, and high-throughput mNGS technology to ensure an accurate diagnosis. Furthermore, we conducted a literature review and analyzed 311 cases of mucormycosis published in the public databases between 2021 and 2024 to assess the underlying pathological characteristics.

Of the 15 cases treated in our institute, ten (66.7%) were males, with a median age of 41 (range 4-78),five (33.3%) were females, with a median age of 58.5 (range 32-85). Compared to other detection methods including PAS/PASM staining, mNGS proved effective in diagnosing typical mucormycosis infections in 15 of the patients in this study. The literature review of 311 cases indicated that the lungs and bronchi were the main sites of infection, followed by the nasal cavity, brain, and skin. Diabetes emerged as the most prevalent underlying condition, present in more than 40% of cases. Other internal and immune system disorders, such as immunodeficiency disease, were also associated with an increased risk of infection.

MNGS is an effective diagnostic tool for mucormycosis.