Cryptococcus Neoformans Osteomyelitis of the Right Ankle Diagnosed by Metagenomic Next-Generation Sequencing in a HIV-Negative Patient with Tuberculous Lymphadenitis and Pulmonary Tuberculosis: A Case Report and Recent Literature Review

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-09-04 DOI:10.2147/idr.s476270

Yao Qin, Xingwu Zou, Yanghui Jin, Jinmeng Li, Qingshan Cai

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引用次数: 0

Abstract

Aim: Cryptococcus neoformans osteomyelitis coupled with tuberculosis and tuberculous lymphadenitis, is a rare occurrence in clinical. Diagnostic challenges arise due to the clinical radiological similarity of this condition to other lung infections and the limited and sensitive nature of traditional approaches. Here, we present a case of co-infection diagnosed using Metagenomic Next-Generation Sequencing, highlighting the effectiveness of advanced genomic techniques in such complex scenarios.
Case Presentation: We present a case of a 67-year-old female infected with cryptococcal osteomyelitis and presented with swelling and pain in the right ankle. Following a biopsy of the right ankle joint, Metagenomic Next-Generation Sequencing (mNGS) of the biopsy tissue revealed Cryptococcus neoformans infection. Positive results for Cryptococcus capsular antigen and pathological findings confirmed the presence of Cryptococcus neoformans. The patient underwent surgical debridement, coupled with oral fluconazole treatment (300mg/day), leading to the resolution of symptoms.
Conclusion: Cryptococcus neoformans is an uncommon cause of ankle infection. Metagenomic Next-Generation Sequencing (mNGS) serves as a valuable diagnostic tool, aiding clinicians in differentiating cryptococcal osteomyelitis from other atypical infections.

Keywords: Cryptococcus neoformans, tuberculosis, diagnosis, metagenomic next-generation sequencing, mNGS

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通过元基因组下一代测序确诊的右踝关节隐球菌骨髓炎（HIV 阴性患者伴结核性淋巴结炎和肺结核）：病例报告和最新文献综述

目的：新型隐球菌骨髓炎合并结核病和结核性淋巴结炎在临床上十分罕见。由于这种病症与其他肺部感染在临床放射学上的相似性，以及传统方法的局限性和敏感性，给诊断带来了挑战。在此，我们介绍一例使用元基因组下一代测序技术诊断出的合并感染病例，以突出先进基因组技术在此类复杂情况下的有效性：我们介绍了一例感染了隐球菌骨髓炎的 67 岁女性病例，患者表现为右脚踝肿胀和疼痛。对右踝关节进行活检后，活检组织的元基因组下一代测序（mNGS）显示感染了新型隐球菌。隐球菌荚膜抗原阳性结果和病理结果证实了新生隐球菌的存在。患者接受了手术清创，同时口服氟康唑治疗（300 毫克/天），症状得到缓解：结论：新生隐球菌是脚踝感染的一个不常见原因。元基因组下一代测序（mNGS）可作为一种有价值的诊断工具，帮助临床医生区分隐球菌性骨髓炎和其他非典型感染：新型隐球菌结核病诊断元基因组下一代测序 mNGS

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.