Rapid diagnosis of Propionibacterium acnes infection in patient with hyperpyrexia after hematopoietic stem cell transplantation by next-generation sequencing: a case report

作者：Mingzhi Ye, Wei Wei, Zhikai Yang, Yingzhen Li, Shaomin Cheng, Kang Wang, Tianliangwen Zhou, Jingmeng Sun, Sha Liu, Na Ni, Hui Jiang, Hua Jiang · 发表于：BMC Infectious Diseases · 年份：2015 · DOI：10.1186/s12879-015-1306-0 · 被引用次数：24 · 研究领域：Acne and Rosacea Treatments and Effects、Orthopedic Infections and Treatments、Bacterial Identification and Susceptibility Testing

BACKGROUND: The rapid determination of pathogenic agent is very important to clinician for guiding their clinical medication. However, current diagnostic methods are of limitation in many aspects, such as detecting range, time-consuming, specificity and sensitivity. In this report, we apply our new-developing pathogen detection method to clarify that Propionibacterium acnes is the causative agent of a two-year-old boy with juvenile myelomonocytic leukemia presenting clinical symptoms including serious rash and hyperpyrexia while traditional clinical methods of diagnosis fail to detect the pathogenic agent and multiple antimicrobial drugs are almost ineffective Propionibacterium acnes is confirmed to be the infectious agent by quantitative real-time polymerase chain reaction. CASE PRESENTATION: After haploidentical hematopoietic stem cell transplantation, a two-year-old boy with juvenile myelomonocytic leukemia presented to a pediatrist in a medical facility with hyperpyrexia and red skin rash which later changed to black skin rash all over his body. Traditional diagnostic assays were unrevealing, and several routine antimicrobial treatments were ineffective, including the vancomycin, meropenem, tobramycin, cefepime and rifampin. In this case, pediatrist resorted to the next-generation sequencing technology for uncovering potential pathogens so as to direct their use of specific drugs against pathogenic bacteria. Therefore, based on the BGISEQ100 (Ion Proton System) which perf...