Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report
BackgroundMucormycosis commonly occurs in immunosuppressed patients with hematological diseases, which can be life-threatening. However, many cases are often misdiagnosed due to lack of specific clinical manifestations. Additionally, the traditional blood culture or serological testing, with a high...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1089196/full |
| _version_ | 1811170386583224320 |
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| author | Meixiao Shen Qian Li Zhaocheng Zeng Dongxu Han Xiansheng Luo |
| author_facet | Meixiao Shen Qian Li Zhaocheng Zeng Dongxu Han Xiansheng Luo |
| author_sort | Meixiao Shen |
| collection | DOAJ |
| description | BackgroundMucormycosis commonly occurs in immunosuppressed patients with hematological diseases, which can be life-threatening. However, many cases are often misdiagnosed due to lack of specific clinical manifestations. Additionally, the traditional blood culture or serological testing, with a high false-negative rate, is time-consuming. Thus, precise and timely diagnosis of infections is essential for the clinical care of infected patients.Case presentationWe report a 29-year-old Chinese man with acute myeloid leukemia (AML) who developed febrile neutropenia after the first course of induction chemotherapy. He received empirical antibiotics, which did not relieve his symptoms. No pathogen was detected by traditional microbiologic assays, while Mucor indicus was identified by metagenomic next-generation sequencing (mNGS) in the blood specimen. Liposomal amphotericin B (LAmB) was used, resulting in the patient’s temperature returning to normal. A few days later, abdominal computed tomography (CT) scan showed multiple liver abscesses; fluorescence staining, histopathology, and mNGS identified the causative agent—M. indicus. Posaconazole was combined with LAmB as long-term antifungal treatment. Finally, the patient received allogeneic hematopoietic stem cell transplantation successfully after controlled infection. During follow-up 1 year after transplantation, the number of liver abscesses was reduced to one and remained stable.ConclusionThis report described the first case of an AML patient diagnosed with culture-negative disseminated infections caused by M. indicus leading to rare hepatic manifestations using mNGS of peripheral blood and liver biopsy. LAmB combined with posaconazole was given in time, resulting in a favorable outcome. mNGS is a new method that assists in detecting the probable pathogen and increases the accuracy of identifying an etiology. |
| first_indexed | 2024-04-10T16:55:59Z |
| format | Article |
| id | doaj.art-1194a676829e49e9aa08663a186b1a01 |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-04-10T16:55:59Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-1194a676829e49e9aa08663a186b1a012023-02-07T05:49:51ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882023-02-011310.3389/fcimb.2023.10891961089196Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case reportMeixiao Shen0Qian Li1Zhaocheng Zeng2Dongxu Han3Xiansheng Luo4Department of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, ChinaGenskey Medical Technology Co., Ltd, Beijing, ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, ChinaGenskey Medical Technology Co., Ltd, Beijing, ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, ChinaBackgroundMucormycosis commonly occurs in immunosuppressed patients with hematological diseases, which can be life-threatening. However, many cases are often misdiagnosed due to lack of specific clinical manifestations. Additionally, the traditional blood culture or serological testing, with a high false-negative rate, is time-consuming. Thus, precise and timely diagnosis of infections is essential for the clinical care of infected patients.Case presentationWe report a 29-year-old Chinese man with acute myeloid leukemia (AML) who developed febrile neutropenia after the first course of induction chemotherapy. He received empirical antibiotics, which did not relieve his symptoms. No pathogen was detected by traditional microbiologic assays, while Mucor indicus was identified by metagenomic next-generation sequencing (mNGS) in the blood specimen. Liposomal amphotericin B (LAmB) was used, resulting in the patient’s temperature returning to normal. A few days later, abdominal computed tomography (CT) scan showed multiple liver abscesses; fluorescence staining, histopathology, and mNGS identified the causative agent—M. indicus. Posaconazole was combined with LAmB as long-term antifungal treatment. Finally, the patient received allogeneic hematopoietic stem cell transplantation successfully after controlled infection. During follow-up 1 year after transplantation, the number of liver abscesses was reduced to one and remained stable.ConclusionThis report described the first case of an AML patient diagnosed with culture-negative disseminated infections caused by M. indicus leading to rare hepatic manifestations using mNGS of peripheral blood and liver biopsy. LAmB combined with posaconazole was given in time, resulting in a favorable outcome. mNGS is a new method that assists in detecting the probable pathogen and increases the accuracy of identifying an etiology.https://www.frontiersin.org/articles/10.3389/fcimb.2023.1089196/fullmucor indicusdisseminated mucormycosismetagenomic next-generation sequencingacute myeloid leukemialiver abscessallogeneic hematopoietic stem cell transplantation |
| spellingShingle | Meixiao Shen Qian Li Zhaocheng Zeng Dongxu Han Xiansheng Luo Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report Frontiers in Cellular and Infection Microbiology mucor indicus disseminated mucormycosis metagenomic next-generation sequencing acute myeloid leukemia liver abscess allogeneic hematopoietic stem cell transplantation |
| title | Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report |
| title_full | Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report |
| title_fullStr | Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report |
| title_full_unstemmed | Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report |
| title_short | Mucor indicus caused disseminated infection diagnosed by metagenomic next-generation sequencing in an acute myeloid leukemia patient: A case report |
| title_sort | mucor indicus caused disseminated infection diagnosed by metagenomic next generation sequencing in an acute myeloid leukemia patient a case report |
| topic | mucor indicus disseminated mucormycosis metagenomic next-generation sequencing acute myeloid leukemia liver abscess allogeneic hematopoietic stem cell transplantation |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1089196/full |
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