Open AccessPneumocystis jiroveci pneumonia with cytomegalovirus infection diagnosed by metagenomic next-generation sequencing in a patient with nephrotic syndrome
Author(s) -
Qian Yu,
Xuchun Ding,
Wen Wang,
Yafang Lou
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026842
Subject(s) - medicine , bronchoalveolar lavage , cytomegalovirus , pneumonia , pneumocystis pneumonia , trimethoprim , intensive care medicine , pneumocystis jirovecii , immunology , antibiotics , virus , viral disease , lung , microbiology and biotechnology , herpesviridae , biology
Opportunistic infection with multiple pathogens currently has become less uncommon since the application of immunosuppressant or corticosteroid in non- Human immunodeficiency virus patients. However, the clinical diagnosis of the co-infection remains difficult since the uncertainty and deficiency of the microbiologic testing methods. Patient concerns: A 66-year-old male patient was admitted to our hospital with chest stuffiness, shortness of breath and elevated body temperature. Diagnosis: He was diagnosed with the co-infection of Pneumocystis jiroveci and cytomegalovirus by metagenomic next-generation sequencing of bronchoalveolar lavage fluid after bronchoscopy. Interventions: The patient was empirically treated with broad-spectrum antibiotics, trimethoprim/ sulfamethoxazole and ganciclovir in the beginning of the admission. Outcomes: The condition of this patient was not improved even with the intervention at the early stage of the disease. His family requested discharge after 24 inpatient days. Lessons: This case highlights the application of metagenomic next-generation sequencing in the clinical diagnosis of pulmonary co-infection. Suitable prophylaxis, necessary clinical awareness and accurate diagnosis are indispensable for immunocompromised patients with pulmonary infection.