宏基因组二代测序技术在艾滋病合并肺诺卡菌病诊断中的应用(附1例报告)  

Application of the metagenomic next-generation sequencing in diagnosis of AIDS with pulmonary nocar⁃diosis(a case report)

作　　者：赵蕊[1] 邹俊[1] ZHAO Rui;ZOU Jun(Department of Infectious Diseases,The Fourth People's Hospital of Nanning,Nanning 530023,China)

机构地区：[1]南宁市第四人民医院[广西艾滋病临床治疗中心(南宁)]感染科,广西南宁530023

出　　处：《老年医学研究》2023年第1期39-42,共4页Geriatrics Research

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200126,高通量测序在艾滋病机会性感染诊断中的应用价值)。

摘　　要：宏基因组二代测序技术(mNGS)可对感染标本直接进行高通量测序,为复杂性感染提供快速精准诊断。本文分析1例艾滋病(AIDS)合并肺诺卡菌病患者临床表现及诊疗经过,探讨mNGS在诊断中的应用情况,为AIDS合并诺卡菌感染的诊治提供经验思路。患者入院时按常规临床症状、实验室检查等资料初始误诊为细菌性肺炎、肺结核,后结合mNGS诊断为肺诺卡菌感染,经经验性应用复方磺胺甲[口恶]唑联合阿米卡星抗诺卡菌治疗好转出院。该病例提示在免疫缺陷合并感染的患者中,应用mNGS进行病原体检测可指导感染性疾病诊断。Metagenomic next-generation sequencing(mNGS)can directly carry out high-throughput sequencing of infected specimens,and retain and detect all pathogen information in the samples.In this paper,the clinical manifestations,diagnosis and treatment of a case of AIDS patients with pulmonary nocardia infection were analyzed,and relevant literature was reviewed to provide experience and ideas for the diagnosis and treatment of AIDS patients with pulmonary nocardia infection.On admission,the patient was initially misdiagnosed as bacterial pneumonia and tuberculosis according to routine clinical symptoms,laboratory examination and other data,and later diagnosed as pulmonary nocardia infection combined with mNGS.After empirical treatment with compound sulfamethoxazole combined with amicacin against nocardia,the patient was discharged with improvement.This case suggests that the application of mNGS for pathogen detection can guide the diagnosis of infectious diseases in patients with immunodeficiency and infection.

关 键 词：宏基因组二代测序技术 艾滋病 肺诺卡菌病 

分 类 号：R512.91[医药卫生—内科学] R563[医药卫生—临床医学]