Next-generation sequencing technology for detecting pulmonary fungal infection in bronchoalveolar lavage fluid of a patient with dermatomyositis: a case report and literature review

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Abstract

Background

Invasive fungal pneumonia is a severe infectious disease with high mortality in immunocompromised patients. However, the clinical diagnosis of the pathogen(s) remains difficult since microbiological evidence is difficult to acquire.

Case presentation

Here, we report a case of pulmonary fungal infection detected by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) in a 61-year-old male with corticosteroid-treated dermatomyositis. Cytomegalovirus and influenza A virus infections were confirmed by nucleic acid detection and treated with antiviral medicine. The patient had been diagnosed with severe pneumonia and treated with empiric broad-spectrum antibacterial and antifungal drugs before bronchoscopy was performed. The patient responded poorly to those empiric treatments. Three fungi were found by NGS in the BALF, namely, Pneumocystis jirovecii, Aspergillus fumigatus and Rhizopus oryzae. After adjusting the patient’s treatment plan according to the NGS results, he improved significantly.

Conclusions

This case highlights the combined application of NGS and traditional tests in the clinical diagnosis of pulmonary invasive fungal disease. NGS is proposed as an important adjunctive diagnostic approach for identifying uncommon pathogens.

Related collections

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Author and article information

Contributors

Kaiyu Zhang: zhangky2000@aliyum.com

Chen Yu: 191985540@qq.com

Yuxiang Li: yuxiangli2@aliyun.com

Yang Wang:

ORCID: http://orcid.org/0000-0001-8055-9522

wyang@jlu.edu.cn

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect. Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 17 August 2020

Publication date PMC-release: 17 August 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 608

Affiliations

[1 ]GRID grid.430605.4, Department of Infectious Diseases, , the First Hospital, Jilin University, ; Changchun, 130021 Jilin China

[2 ]GRID grid.266902.9, ISNI 0000 0001 2179 3618, Department of Pediatrics, , University of Oklahoma Health Sciences Center, ; Oklahoma City, OK 73104 USA

Author information

Yang Wang http://orcid.org/0000-0001-8055-9522

Article

Publisher ID: 5341

DOI: 10.1186/s12879-020-05341-8

PMC ID: 7433194

PubMed ID: 32807082

SO-VID: 2094bf72-98c4-41f2-a3a1-fcbd476edd69

License:

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