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Tuberculosis diseminada secundaria a coinfección polimicrobiana tras inmunoterapia a largo plazo para mesotelioma

Lingyin Xia¹, Jianning Xu², Zhiqing Chen¹

¹Jiangxi Provincial Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China.

Respiratory medicine case reports

|February 5, 2026

Abstract:

Malignant pleural mesothelioma (MPM), particularly its sarcomatoid subtype, is a highly aggressive sarcoma of the pleural lining with a dismal prognosis. Prolonged use of immune checkpoint inhibitors (ICIs), while improving survival in selected patients, can induce profound immunosuppression, increasing susceptibility to life-threatening opportunistic infections. This report describes a 77-year-old male with sarcomatoid MPM who developed fatal disseminated tuberculosis (TB), accompanied by concurrent Aspergillus and herpesvirus infections during extended immunotherapy. The case underscores the critical role of metagenomic next-generation sequencing (mNGS) in enabling rapid diagnosis of atypical TB reactivation in an immunocompromised host, even when conventional cultures are negative. mNGS identified co-infections with Aspergillus flavus and herpesviruses (HHV-5, HHV-4, HHV-1), demonstrating its superiority in polymicrobial infection detection.

Palabras clave:

Tuberculosis diseminada Inhibidores de puntos de control inmunitario Secuenciación de próxima generación metagenómica (mNGS)Infecciones oportunistas Mesotelioma sarcomatoide

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