scholarly journals Application of Metagenomic Next-Generation Sequencing to Diagnose Pneumocystis jirovecii Pneumonia in Kidney Transplantation Recipients

2021 ◽  
Vol 26 ◽  
Author(s):  
Jia Xu ◽  
Yedong Yu ◽  
Junhao Lv ◽  
Sisi Yang ◽  
Jianyong Wu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Next Generation Sequencing ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Next Generation ◽  
Generation Sequencing

scholarly journals Application of Metagenomic Next-Generation Sequencing in the Diagnosis and Treatment Guidance of Pneumocystis jirovecii Pneumonia in Renal Transplant Recipients

2021 ◽  
Author(s):  
Feng Zhang ◽  
Jia Chen ◽  
He Huang ◽  
Rangjiao Liu ◽  
Xiaomei Ren ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Univariate Analysis ◽  
Clinical Decision ◽  
Torque Teno Virus ◽  
Pneumocystis Jirovecii ◽  
Control Group ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Renal Transplant Recipients ◽  
Next Generation ◽  
Generation Sequencing

Abstract Background Pneumocystis jirovecii pneumonia (PJP) is difficult to be diagnosed, so this study explored if PJP could be diagnosed by metagenomic next-generation sequencing (mNGS) and if mNGS could guide the therapy of PJP. Methods mNGS successfully diagnosed 13 out of 14 PJP recipients with 11 through peripheral blood samples, verified by PCR. Ten non-PJP recipients were enrolled as the control group. Results Blood tests revealed a high β-Dglucan (BDG) level in all recipients with PJP during the hospitalization. Four (28.6%) of 14 PJP patients were infected with cytomegalovirus simultaneously, while 8 (57.1%) suffered from a combined infection caused by Torque teno virus. Five (35.7%) of 14 cases died of PJP or the subsequent bacteremias/bacterial pneumonia with a longer interval between the onset and diagnosis of/the available therapy against PJP than survival cases. Univariate analysis of Characteristics between PJP and non-PJP recipients revealed that BDG assays was higher at the admission in PJP group ( P = 0.011). Conclusion This present study supports the value of mNGS detection of blood sample in diagnosing PJP, which could assist clinical decision for therapy against PJ and improve outcome of PJP. The study also highlights the sensitivity of BDG assays. Cytomegalovirus and Torque teno virus infections often occur at the same time of PJP, thus can be alerts of PJP.

scholarly journals Application of Metagenomic Next-Generation Sequencing in The Diagnosis and Treatment Guidance of Pneumocystis Jirovecii Pneumonia in Renal Transplant Recipients

2021 ◽  
Author(s):  
Feng Zhang ◽  
Jia Chen ◽  
He Huang ◽  
Rangjiao Liu ◽  
Xiaomei Ren ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Univariate Analysis ◽  
Clinical Decision ◽  
Torque Teno Virus ◽  
Pneumocystis Jirovecii ◽  
Control Group ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Renal Transplant Recipients ◽  
Next Generation ◽  
Generation Sequencing

Abstract Purpose: Pneumocystis jirovecii pneumonia (PJP) is difficult to be diagnosed, so this study explored if PJP could be diagnosed by metagenomic next-generation sequencing (mNGS) and if mNGS could guide the therapy of PJP. Methods: mNGS successfully diagnosed 13 out of 14 PJP recipients with 11 through peripheral blood samples, verified by PCR. Ten non-PJP recipients were enrolled as the control group. Results: Blood tests revealed a high β-Dglucan (BDG) level in all recipients with PJP during the hospitalization. Four (28.6%) of 14 PJP patients were infected with cytomegalovirus simultaneously, while 8 (57.1%) suffered from a combined infection caused by Torque teno virus. Five (35.7%) of 14 cases died of PJP or the subsequent bacteremias/bacterial pneumonia with a longer interval between the onset and diagnosis of/the available therapy against PJP than survival cases. Univariate analysis of Characteristics between PJP and non-PJP recipients revealed that BDG assays was higher at the admission in PJP group ( P =0.011). Conclusions: This present study supports the value of mNGS detection of blood sample in diagnosing PJP, which could assist clinical decision for therapy against PJ and improve outcome of PJP. The study also highlights the sensitivity of BDG assays. Cytomegalovirus and Torque teno virus infections often occur at the same time of PJP, thus can be alerts of PJP.

scholarly journals Rare Presentation of Toxoplasma Pneumonitis in the Absence of Neurological Symptoms in an AIDS Patient and Use of Next-Generation Sequencing for Diagnosis

2020 ◽  
Author(s):  
Moni Roy ◽  
Nikhut Siddique ◽  
Bindu Bathina ◽  
Sharjeel Ahmad
Keyword(s):  
Next Generation Sequencing ◽  
Opportunistic Infections ◽  
Miliary Tuberculosis ◽  
Neurological Symptoms ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Next Generation ◽  
Rare Presentation ◽  
Immunodeficiency Syndrome ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Toxoplasma gondii is a known cause of encephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Toxoplasma pneumonitis is a manifestation of extracerebral toxoplasmosis and can be clinically indistinguishable from other opportunistic infections including Pneumocystis jirovecii pneumonia (PJP) and miliary tuberculosis. In this case report, Toxoplasma pneumonitis and disseminated toxoplasmosis was diagnosed using next-generation sequencing (NGS) and polymerase chain reaction (PCR) assessment. NGS can detect microbial cell-free DNA (cfDNA) circulating in the plasma of over 1,000 pathogens. This case is a rare presentation of Toxoplasma pneumonitis in the absence of neurological symptoms and we discuss the use of NGS of microbial cfDNA and PCR tests that may be utilized for the timely diagnosis of such challenging cases.

scholarly journals Severe pulmonary co-infection with varicella-zoster virus, Pneumocystis jirovecii and Cytomegalovirus: a case report

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110707
Author(s):  
Zhijiang Qi ◽  
Yanting Sun ◽  
Jun Li ◽  
Yingjie Wang ◽  
Haining Lu ◽  
...  
Keyword(s):  
Case Report ◽  
Next Generation Sequencing ◽  
Varicella Zoster Virus ◽  
Pneumocystis Jirovecii ◽  
Imaging Features ◽  
Severe Respiratory Failure ◽  
Next Generation ◽  
Varicella Zoster ◽  
Immunosuppressed Patients ◽  
Generation Sequencing

Pneumocystis jirovecii, Cytomegalovirus and varicella-zoster virus are all opportunistically infective pathogens, but pulmonary co-infection with these pathogens is rare. Herein, this case report describes a patient with autoimmune haemolytic anaemia treated with methylprednisolone and cyclosporine that presented with rapidly progressive severe respiratory failure. Analysis of microbial nucleic acid sequences in both blood and sputum using next-generation sequencing revealed pulmonary co-infection with Pneumocystis jirovecii, varicella-zoster virus, and possibly Cytomegalovirus. After timely targeted and supportive treatments, the patient recovered. This case report highlights the imaging features of co-infection with these pathogens, the importance of next-generation sequencing for early diagnosis in immunosuppressed patients, and the effects of corticosteroid therapy.

scholarly journals Rapid and precise diagnosis of pneumonia coinfected by Pneumocystis jirovecii and Aspergillus fumigatus assisted by next-generation sequencing in a patient with systemic lupus erythematosus: a case report

2021 ◽  
Author(s):  
Yili Chen ◽  
Lu Ai ◽  
Yingqun Zhou ◽  
Yating Zhao ◽  
Jianyu Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Next Generation Sequencing ◽  
Aspergillus Fumigatus ◽  
Lupus Erythematosus ◽  
Financial Burden ◽  
Pneumocystis Jirovecii ◽  
Clinical Approach ◽  
Next Generation ◽  
Systemic Lupus ◽  
Generation Sequencing

Abstract Background: Pneumocystis jirovecii and Aspergillus fumigatus, are opportunistic pathogenic fungus that has a major impact on mortality in patients with systemic lupus erythematosus. With the potential to invade multiple organs, early and accurate diagnosis is essential to the survival of SLE patients, establishing an early diagnosis of the infection, especially coinfection by Pneumocystis jirovecii and Aspergillus fumigatus, still remains a great challenge.Case presentation: In this case, we reported that the application of next-generation sequencing in diagnosing Pneumocystis jirovecii and Aspergillus fumigatus coinfection in a Chinese girl with systemic lupus erythematosus (SLE). Voriconazole was used to treat pulmonary aspergillosis, besides sulfamethoxazole and trimethoprim (SMZ-TMP), and caspofungin acetate to treat Pneumocystis jirovecii infection for 6 days. On Day 10 of admission, her chest radiograph displayed obvious absorption of bilateral lung inflammation though the circumstance of repeated fever had not improved. Unfortunately, the patient discharged from the hospital since the financial burden, therefore further condition couldn't be tracked.Conclusions: This successful application of the next generation sequencing assisting the rapid diagnosis of Pneumocystis jirovecii and Aspergillus fumigatus coinfection provides a new perspective in the clinical approach against the systematic fungi infections and highlights the potential of this technique in rapid etiological diagnosis.

scholarly journals Rapid and Precise Diagnosis of Pneumonia Coinfected by Pneumocystis Jirovecii and Aspergillus Fumigatus Assisted by Next-generation Sequencing in a Patient With Systemic Lupus Erythematosus: a Case Report

2021 ◽  
Author(s):  
Yili Chen ◽  
Lu Ai ◽  
Yingqun Zhou ◽  
Yating Zhao ◽  
Jianyu Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Next Generation Sequencing ◽  
Aspergillus Fumigatus ◽  
Lupus Erythematosus ◽  
Financial Burden ◽  
Pneumocystis Jirovecii ◽  
Clinical Approach ◽  
Next Generation ◽  
Systemic Lupus ◽  
Generation Sequencing

Abstract Background: Pneumocystis jirovecii and Aspergillus fumigatus, are opportunistic pathogenic fungus that has a major impact on mortality in patients with systemic lupus erythematosus. With the potential to invade multiple organs, early and accurate diagnosis is essential to the survival of SLE patients, establishing an early diagnosis of the infection, especially coinfection by Pneumocystis jirovecii and Aspergillus fumigatus, still remains a great challenge.Case presentation: In this case, we reported that the application of next-generation sequencing in diagnosing Pneumocystis jirovecii and Aspergillus fumigatus coinfection in a Chinese girl with systemic lupus erythematosus (SLE). Voriconazole was used to treat pulmonary aspergillosis, besides sulfamethoxazole and trimethoprim (SMZ-TMP), and caspofungin acetate to treat Pneumocystis jirovecii infection for 6 days. On Day 10 of admission, her chest radiograph displayed obvious absorption of bilateral lung inflammation though the circumstance of repeated fever had not improved. Unfortunately, the patient discharged from the hospital since the financial burden, therefore further condition couldn't be tracked.Conclusions: This successful application of the next generation sequencing assisting the rapid diagnosis of Pneumocystis jirovecii and Aspergillus fumigatus coinfection provides a new perspective in the clinical approach against the systematic fungi infections and highlights the potential of this technique in rapid etiological diagnosis.

scholarly journals Next generation sequencing in early diagnosis of pneumocystis jirovecii pneumonia after chemotherapy: a case report

2019 ◽  
Vol 7 (9) ◽  
pp. 3561
Author(s):  
Donghua Zheng ◽  
Kai Chen ◽  
Fang Xiao ◽  
Na Liu
Keyword(s):  
Case Report ◽  
Next Generation Sequencing ◽  
Early Stage ◽  
Severe Pneumonia ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Next Generation ◽  
Pneumocystis Jiroveci ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

The incidence of Pneumocystis pneumonia is increasing in immunosuppressive patients. How to diagnose and treat Pneumocystis pneumonia in the early stage has become an important issue for clinicians. The development of Next-generation Sequencing (NGS) provides technical support for the diagnosis of Pneumocystis pneumonia. Case report: A 14-year-old male patient was diagnosed with T lymphoblastoma and treated with chemotherapy. After chemotherapy, the patient developed bone marrow suppression and was complicated with severe pneumonia. He was given endotracheal intubation and ventilator assisted respiration. Samples of patients' alveolar lavage fluid were obtained, and Next-generation Sequencing (NGS) was used for diagnosis, confirming the pathogen as Pneumocystis jiroveci, which was treated by TMP/SMX. The patient's condition gradually improved, and was finally removed from ventilator and endotracheal tube. Pneumocystis jiroveci is a common opportunistic pathogen in immunosuppressive patients, and Next-generation Sequencing (NGS) can be used for rapid diagnosis of Pneumocystis pneumonia, thus improving the clinical therapeutic effect. 

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