Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report

Coccidioidomycosis is a systemic infection caused by the dimorphic fungus Coccidioides spp., endemic to the Southwestern United States and Central and South America. In this article, we report a case of Coccidioides immitis-induced meningitis in a 27-year-old man who was experiencing recurrent fever...

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Main Authors: Hong Liu, Kaixin Zhou, Chaoran Zhong, Ming Guan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1500014/full
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author Hong Liu
Kaixin Zhou
Chaoran Zhong
Ming Guan
author_facet Hong Liu
Kaixin Zhou
Chaoran Zhong
Ming Guan
author_sort Hong Liu
collection DOAJ
description Coccidioidomycosis is a systemic infection caused by the dimorphic fungus Coccidioides spp., endemic to the Southwestern United States and Central and South America. In this article, we report a case of Coccidioides immitis-induced meningitis in a 27-year-old man who was experiencing recurrent fever and headache. His cerebrospinal fluid (CSF) biochemical markers indicated an infection in the central nervous system. However, repeated routine cultures of the CSF for bacterial detection were all negative. Only metagenomic next-generation sequencing (mNGS) detected low reads of C. immitis. To verify the mNGS results, the Clinical Microbiology Laboratory in Huashan Hospital optimized its culture conditions. Ultimately, 12 days after sampling, the fungal bottle containing the cerebrospinal fluid tested positive. Furthermore, the diagnosis of C. immitis was then confirmed by smear staining combined with morphological characteristics of the colony, which provided an important etiological basis for clinical diagnosis and treatment. As coccidioidomycosis is a rare disease in China, its pathogen-specific diagnostic methods are limited. In this case, we combined two universal methods, mNGS and traditional morphological observation, to confirm the diagnosis. This combined strategy is critical for quick and accurate diagnosis.
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spelling doaj-art-cbf8a82fa492493f8708ea111bf1d4302025-01-22T05:19:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15000141500014Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case reportHong LiuKaixin ZhouChaoran ZhongMing GuanCoccidioidomycosis is a systemic infection caused by the dimorphic fungus Coccidioides spp., endemic to the Southwestern United States and Central and South America. In this article, we report a case of Coccidioides immitis-induced meningitis in a 27-year-old man who was experiencing recurrent fever and headache. His cerebrospinal fluid (CSF) biochemical markers indicated an infection in the central nervous system. However, repeated routine cultures of the CSF for bacterial detection were all negative. Only metagenomic next-generation sequencing (mNGS) detected low reads of C. immitis. To verify the mNGS results, the Clinical Microbiology Laboratory in Huashan Hospital optimized its culture conditions. Ultimately, 12 days after sampling, the fungal bottle containing the cerebrospinal fluid tested positive. Furthermore, the diagnosis of C. immitis was then confirmed by smear staining combined with morphological characteristics of the colony, which provided an important etiological basis for clinical diagnosis and treatment. As coccidioidomycosis is a rare disease in China, its pathogen-specific diagnostic methods are limited. In this case, we combined two universal methods, mNGS and traditional morphological observation, to confirm the diagnosis. This combined strategy is critical for quick and accurate diagnosis.https://www.frontiersin.org/articles/10.3389/fmed.2024.1500014/fullCoccidioides immitiscoccidioidomycosismetagenomic next-generation sequencing (mNGS)diagnosis strategymeningitis
spellingShingle Hong Liu
Kaixin Zhou
Chaoran Zhong
Ming Guan
Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
Frontiers in Medicine
Coccidioides immitis
coccidioidomycosis
metagenomic next-generation sequencing (mNGS)
diagnosis strategy
meningitis
title Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
title_full Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
title_fullStr Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
title_full_unstemmed Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
title_short Combination of metagenomic next-generation sequencing and morphology for identifying Coccidioides immitis: a case report
title_sort combination of metagenomic next generation sequencing and morphology for identifying coccidioides immitis a case report
topic Coccidioides immitis
coccidioidomycosis
metagenomic next-generation sequencing (mNGS)
diagnosis strategy
meningitis
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1500014/full
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AT chaoranzhong combinationofmetagenomicnextgenerationsequencingandmorphologyforidentifyingcoccidioidesimmitisacasereport
AT mingguan combinationofmetagenomicnextgenerationsequencingandmorphologyforidentifyingcoccidioidesimmitisacasereport