Pulmonary Cryptococcosis Diagnosed by Metagenomic Next-Generation Sequencing in a Young Patient With Normal Immune Function: A Case Report

Overview

Journal Front Public Health

Specialty Public Health

Date 2022 Aug 8

PMID 35937275

Authors

Yingyu Zhang

Weiliang Wang

Yingxuan Zhang

Sina Zhai

Han Xia

Xilin Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Pulmonary cryptococcosis (PC) is a serious opportunistic fungal infection that usually occurs in immunocompromised patients. This disease is often difficult to diagnose in time due to its clinical manifestations and radiological feature similar to other pulmonary infections, as well as the low sensitivity of conventional diagnostic methods. Cryptococcosis in immune-competent patients is rare.

Case Presentation: Here we report a case of PC in an immune-competent patient. Tuberculosis was suspected according to radiological features due to the positive T-lymphocyte spot test and pure protein derivative skin test. To further detect the pathogen, bronchoalveolar lavage fluid (BALF) was collected for metagenomic next-generation sequencing (mNGS). (one specific read) was identified by mNGS, indicating the PC of this patient. The following BALF culture and cryptococcal antigen lateral flow assay (CrAg-LFA) test also showed infection, confirming the mNGS detection. Voriconazole (0.4 g daily) was given orally according to the subsequent susceptibility results. After seven months of treatment, the patient's condition improved.

Conclusion: Metagenomic next-generation sequencing (mNGS) is a better diagnostic tool to help clinicians distinguish pulmonary cryptococcosis from other atypical pulmonary infections.

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