Bronchiectasis complicated with Nocardia amamiensis, Mycobacterium tuberculosis and Aspergillus fumigatus infection:a case report

VernacularTitle:支气管扩张合并甜味诺卡菌、结核分枝杆菌和烟曲霉感染1例
Author: Huimei ZHANG ¹ ; Ying DENG ; Qing WEI ; Chuangchuang CAI ; Zhiwei HUANG ; Yuzhen LI
Author Information

1. 深圳市中医院医学检验科，深圳518000
Keywords: Nocardia; Coinfection; Diagnosis
From: Chinese Journal of Laboratory Medicine 2024;47(9):1086-1089
CountryChina
Language:Chinese
Abstract: An elderly female patient was admitted to Shenzhen Traditional Chinese Medicine Hospital on May 4, 2023, due to recurrent cough for 4 years and aggravation with fever for 6 days. Chest CT showed bronchiectasis with pulmonary infection. Sputum smear microscopy indicated the possibility of Nocardia, and sputum fungal culture revealed Aspergillus fumigatus. After several days of anti- Nocardia and anti- Aspergillus fumigatus treatment, the patient′s inflammatory index decreased but she still had a low-grade fever. Effective communication between the laboratory and clinicians facilitated the culture of bronchoalveolar lavage fluid and the detection of metagenomic next-generation sequencing. The patient made progress after receiving anti-infection treatment for three suspected pathogenic bacteria- Nocardia amamiensis, Mycobacterium tuberculosis, and Aspergillus fumigatus-detected by the above methods. For the diagnosis of coinfection, the combination of multiple methods can improve the accuracy of pathogen identification, thereby better guiding clinical treatment.