Application of Metagenomics Next-Generation Sequencing on Diagnosis of Disseminated Infection Caused by Rhizomucor pusillus in an Acute Lymphoblastic Leukemia Patient

• Published in: Infection and drug resistance Vol. 17; pp. 5707 - 5713
• Main Authors: Chen, Hengxin, Qiu, Mingjin, Xu, Hongxu, Guo, Penghao, Peng, Yaqin
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2024; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Acute lymphoblastic leukemia; Acute lymphocytic leukemia; Amphotericin B; Antibiotics; Antifungal agents; Antiparasitic agents; B cells; Blood; Bone marrow; Bronchus; Case Report; Caspofungin; Chemotherapy; China; Development and progression; Diabetes; Diagnosis; Disseminated infection; Fever; Fungal infections; Fungi; Hematology; Imipenem; Inflammation; Lavage; Leukemia; Lymphatic leukemia; Metagenomics; metagenomics next-generation sequencing; Mortality; Mucormycosis; Next-generation sequencing; Pathogens; Patients; Pleural effusion; Posaconazole; Proteins; Rhizomucor pusillus; Serology; Stem cells; Type 2 diabetes; China; metagenomics next-generation sequencing; diagnosis; Rhizomucor pusillus; disseminated infection
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S499419

is one of the major pathogens in mucormycosis. Infection due to is rare and has a high mortality rate, especially disseminated mucormycosis infections. Rapid and accurate pathogen identification is important for the development of targeted antifungal therapies. We presented a case of disseminated infection, identified through metagenomics next-generation sequencing (mNGS), in a 4-year-old patient with acute lymphoblastic leukemia. On days 22, 23, and 28, was detected in bronchoalveolar lavage fluid, blood, and hydrothorax, respectively, through mNGS. The patient developed lung, pleural, and blood disseminated lesions caused by infection. Subsequently, the patient was treated with antifungal therapy, including posaconazole, amphotericin B, and isacconazole, with supportive treatment. However, with the continuous deterioration of symptoms, the patient's family decided to give up treatment. The patient eventually died of multiple-organ failure on day 34. mNGS facilitates prompt diagnosis of disseminated infections. The successful application of mNGS provided a new perspective for the clinician, underscoring the technique's potential for rapid diagnostic etiology. mNGS has the capability to identify pathogens at the species level, which is a significant asset in guiding clinical medication decisions.