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使用下一代测序的元基因组学对mycobacterium avium复杂感染的诊断:一个病例报告

Hongli Li¹, Luqing Wei¹, Fenge Li^1,2

¹Department of Respiratory, Tianjin Beichen Hospital, Tianjin, China.

Frontiers in medicine

|November 3, 2023

概括

下一代元基因组测序快速诊断出Mycobacterium avium细胞内复合体 (MAC) 感染,患者患有严重的血和肺结节. 这种诊断方法在传统测试失败的情况下被证明是有效的,有助于及时治疗和恢复.

科学领域:

肺部病理学肺部病理学
传染性疾病传染性疾病
医学诊断医学诊断医学诊断

背景情况:

非结核菌肺病 (NTM-PD),特别是 Mycobacterium avium 细胞内复合体 (MAC),通常与先前存在的肺部疾病有关.
诊断MAC感染可能具有挑战性,特别是在没有典型风险因素的患者或当常规测试产生负面结果时.
严重的血和双边肺结节是显著的临床表现,需要准确的病因诊断.

研究的目的:

报告一个MAC感染病例,呈现出严重的血和双边肺结节.
在具有挑战性的MAC感染病例中评估元基因组下一代测序 (mNGS) 的诊断实用性.
要强调考虑MAC感染的重要性,即使没有易感条件.

主要方法:

一个61岁的男性的临床表现,患有严重的血和双边肺结节.
最初的诊断工作包括唾液和支气管洗液 (BALF) 酸快细菌试验和GeneXpert,所有这些都产生了负面结果.
甲基因组下一代测序 (mNGS) 在肺结节和BALF样本上进行,随后进行传统的MAC培养以确认.

主要成果:

在3天内,mNGS在肺结节和BALF样本中迅速识别了MAC.
传统的MAC培养在2个月后证实了BALF中MAC的存在.
经过2个月的适当MAC治疗,患者的肺结节明显改善,通过高分辨率胸部计算机断层扫描证实了这一点.

结论:

MAC感染是病人的严重血和肺结节的原因,强调了诊断警的必要性.
下一代元基因组测序 (mNGS) 显示出作为MAC感染的快速有效诊断工具的巨大潜力.
这一案例凸显了mNGS在诊断NTM疾病中的实用性,特别是当传统方法无法得出结论时.

关键词:

这种细菌是Mycobacterium avium.诊断诊断诊断诊断诊断诊断基因组学的下一代测序.没有结核的真菌菌菌.肺部疾病是一种肺部疾病.

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