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CASE REPORT

Pneumonia Caused by Coinfection with Cytomegalovirus and Pneumocystis jirovecii in an HIV-Negative Infant Diagnosed by Metagenomic Next-Generation Sequencing

, , , , , , & show all
Pages 3417-3425 | Published online: 30 Jun 2022

Figures & data

Figure 1 Timeline of the patient’s clinical manifestations and treatment.

Notes:
: CT;
: CR;
: blood culture;
: sputum culture;
: BALF culture;
: NGS of blood;
: NGS of sputum;
: NGS of BALF;
:G test;
: CMV test;
: time is not clear.
Abbreviations: D, death; CTX, cefotaxime; IPM, imipenem; DXM, dexamethasone; PAT, prednisone acetate tablets; IVIG, intravenous immunoglobulin; MEM, meropenem; CRM, ceftriaxone sodium; CXM, cefuroxime sodium; CFM, cefixime; AZM, azithromycin; MSSI, methylprednisolone sodium succinate for injection; VN, vancomycin; TMP-SMX, trimethoprim-sulfamethoxazole; CAS, caspofungin; SCF, cefoperazone sodium and sulbactam sodium for injection.
Figure 1 Timeline of the patient’s clinical manifestations and treatment.

Figure 2 Imaging data of lungs. (A) on the 1st day of admission, CR showed exudation in both lungs and large effusion in the right pleural cavity. (B) CR indicated a large amount of diffuse patchy exudation in both lung fields on the 4th day. (C and D) Chest CT scans showed dense shadow and consolidation were diffused in both lungs on the 12th day. (E and F) on the day before discharge day, CR showed exudation and consolidation still existed in large areas of the lungs.

Figure 2 Imaging data of lungs. (A) on the 1st day of admission, CR showed exudation in both lungs and large effusion in the right pleural cavity. (B) CR indicated a large amount of diffuse patchy exudation in both lung fields on the 4th day. (C and D) Chest CT scans showed dense shadow and consolidation were diffused in both lungs on the 12th day. (E and F) on the day before discharge day, CR showed exudation and consolidation still existed in large areas of the lungs.

Table 1 The Pathogen and Sequence Reads Detected by mNGS in Different Specimen Types

Figure 3 Blood mGNS gene sequence coverage depth map for PJ (A) and CMV (B); sputum mGNS gene sequence coverage depth map for PJ (C) and CMV (D). Multiple Mapping: Multiple comparing 2 or more species. Unique Mapping: unique comparison to a certain species. Identity: the identity of the sequence compared to the reference genome. The abscissa is the size and location of the genome; the ordinate on the left is the number of sequenced sequences of the reference genome; the ordinate on the right is the consistency of the sequenced sequence with the reference genome. Peak map of PJ nucleic acid by Sanger sequencing (E).

Figure 3 Blood mGNS gene sequence coverage depth map for PJ (A) and CMV (B); sputum mGNS gene sequence coverage depth map for PJ (C) and CMV (D). Multiple Mapping: Multiple comparing 2 or more species. Unique Mapping: unique comparison to a certain species. Identity: the identity of the sequence compared to the reference genome. The abscissa is the size and location of the genome; the ordinate on the left is the number of sequenced sequences of the reference genome; the ordinate on the right is the consistency of the sequenced sequence with the reference genome. Peak map of PJ nucleic acid by Sanger sequencing (E).