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Case Report: Next-Generation Sequencing in Diagnosis of Pneumonia Due to Pneumocystis jirovecii and Cytomegalovirus in a Patient With HIV Infection.
Xie, Yirui; Ruan, Bing; Jin, Lingxiao; Zhu, Biao.
  • Xie Y; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, The First Affiliated Hosp
  • Ruan B; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, The First Affiliated Hosp
  • Jin L; Department of Infectious Diseases, People's Hospital of Pujiang County, Jinhua, China.
  • Zhu B; School of Medicine, Pujiang Branch of the First Affiliated Hospital, Zhejiang University, Hangzhou, China.
Front Med (Lausanne) ; 8: 653294, 2021.
Article in English | MEDLINE | ID: covidwho-1186837
ABSTRACT

Background:

Pulmonary infections remain a significant cause of morbidity and mortality in immunocompromised patients. The pathogens spectrum of pulmonary infection that can affect patients with human immunodeficiency virus (HIV) is wide such as bacterial, fungal, viral, parasitic organisms, and so on. The risk of multi-pathogenic pneumonia is higher in HIV-infected patients. However, the fast and accurate diagnosis of multi-pathogenic pneumonia is challenging because of the limitations of current conventional tests. Case Presentation Here, we report a case of pneumonia due to Pneumocystis jirovecii and cytomegalovirus (CMV) in a 22-year-old male with newly diagnosed HIV infection. Blood tests revealed a low CD4 count, a chest computed tomography (CT) scan showed extensive ground-glass opacities in the bilateral lung with multiple cavity lesions in the left upper lung. Microscopic examination of stained sputum and bronchoalveolar lavage fluid (BALF) smear specimens did not find any pathogens. There was also no evidence of pathogens known to cause pneumonia in bacteria and fungi culture tests and virus antibodies such as EBV, CMV, and COVID-19. The nucleic acid of CMV in blood was reported by quantitative PCR. Next-generation sequencing (NGS) analysis of BALF specimens identified a large number of P. jirovecii and CMV reads, and confirmed the diagnosis of pneumonia due to P. jirovecii and CMV. Following the patient's treatment with anti-PCP and anti-CMV, the patient was cured and discharged.

Conclusions:

This case highlights the combined application of NGS in the clinical diagnosis of multi-pathogenic pneumonia in an HIV-infected patient. NGS is proposed as an important adjunctive diagnostic approach for identifying pathogens of multi-pathogenic pneumonia in HIV-infected patients.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Diagnostic study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Diagnostic study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article