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CASE REPORT article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1283320
This article is part of the Research Topic Allogenic Hematopoietic Cell Transplant in Hematological Malignancies: Controversies and Perspective View all 6 articles

Difficult Diagnosis of Mycobacterium Tuberculosis Infection in Patients after Allogeneic Hematopoietic Stem Cell Transplantation: Two Case Reports and Literature Review

Provisionally accepted
Zhenghua Liu Zhenghua Liu Dali Cai Dali Cai *Nan Su Nan Su *
  • Department of Hematology, The First Hospital of China Medical University, Shenyang, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Background: Mycobacterium tuberculosis (MTB) is a relatively infrequent infection encountered during hematopoietic stem cell transplantation (HSCT). The identification of MTB following HSCT remains a complex task, with delayed detection and misdiagnosis potentially resulting in unfavorable outcomes. Metagenomic next-generation sequencing (mNGS) represents a novel, highly sensitive and rapid diagnostic tool in clinical settings for discerning intricate infections and detecting exceedingly rare pathogens.Methods: With the aid of mNGS, we diagnosed MTB in the lymph nodes and lungs of two patients with hematological diseases following allogeneic peripheral blood hematopoietic stem cell transplantation. Both patients presented with fever, localized symptoms and clinical signs. Following inconclusive results from routine tests, impractical biopsy procedures and unsuccessful responses to empirical treatments, mNGS was employed as a final recourse, revealing DNA fragments of MTB in blood samples.Results:The diagnoses were ultimately confirmed in conjunction with additional clinical evidence. The application of mNGS in MTB cases after allogeneic HSCT has rarely been reported. The mNGS technique can provide a prompt and highly sensitive indication leading to the definitive diagnosis of MTB in complex post-transplant scenarios.

    Keywords: Mycobacterium tuberculosis, Hematopoietic Stem Cell Transplantation, mNGS (metagenomic next-generation sequencing), Allo HSCT, MTB (Mycobacterium tuberculosis)

    Received: 25 Aug 2023; Accepted: 08 May 2024.

    Copyright: © 2024 Liu, Cai and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Dali Cai, Department of Hematology, The First Hospital of China Medical University, Shenyang, 110000, Liaoning Province, China
    Nan Su, Department of Hematology, The First Hospital of China Medical University, Shenyang, 110000, Liaoning Province, China

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