Metagenomic next-generation sequencing in diagnosing Pneumocystis jirovecii pneumonia: A case report

Abstract: It remains a huge challenge for clinicians to diagnose Pneumocystis jirovecii pneumonia (PJP) by a conventional method, which leads to delay in diagnosing PJP, accounting for higher mortality in patients with rheumatoid arthritis (RA). A 69-year-old woman, who suffered from RA for years, developed acute respiratory failure. The computed tomography scan showed diffused effusion and ground glass opacity in both lungs, which could not be differentiated from interstitial pneumonia. Metagenomic next-generation sequencing (mNGS) revealed P. jirovecii in both serum and bronchoalveolar lavage fluid with reads per million (RPM) of 17 and 437, while other diagnostic tests did not detect any pathogenic microorganism. The results were verified by quantitative polymerase chain reaction (mtSSU region) against the same samples. The DNA RPM of P. jirovecii declined notably after treatment with trimethoprim/sulfamethoxazole. The patient was discharged without treatment and finally passed away. This case fully highlights the sensitivity of mNGS in early diagnosis of PJP, which is of great significance for prognosis and treatment. Nonetheless, the clinical application of mNGS is worth further standardization and normalization.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Metagenomic next-generation sequencing in diagnosing Pneumocystis jirovecii pneumonia: A case report ; volume:17 ; number:1 ; year:2022 ; pages:938-943 ; extent:6
Open life sciences ; 17, Heft 1 (2022), 938-943 (gesamt 6)

Creator
Zhang, Yuan
Zeng, Zhaoshang
Li, Fenghui
Peng, Zhiyun
Xia, Han
Zeng, Yunyi
Chen, Haimin
Wang, Yingjing
Xie, Weining
Zhang, Yanhua
Tang, Zhongxiang

DOI
10.1515/biol-2022-0094
URN
urn:nbn:de:101:1-2022081811361486601460
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:22 AM CEST

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Associated

  • Zhang, Yuan
  • Zeng, Zhaoshang
  • Li, Fenghui
  • Peng, Zhiyun
  • Xia, Han
  • Zeng, Yunyi
  • Chen, Haimin
  • Wang, Yingjing
  • Xie, Weining
  • Zhang, Yanhua
  • Tang, Zhongxiang

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