AUTHOR=Niu Siqiang , Zhao Limin 

TITLE=Metagenomic next-generation sequencing clinches the diagnosis of Legionella pneumonia in a patient with acute myeloid leukemia: A case report and literature review

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.924597

DOI=10.3389/fcimb.2022.924597

ISSN=2235-2988

ABSTRACT=Legionnaires' disease caused by Legionella pneumophila is a multi-system disease with life-threatening acute and severe form of pneumonia. The widely-existed Legionella pneumophila, with its clinical manifestations lacking specific characteristics, is similar to those of typical and atypical pneumonia. Current diagnostic scores and radiologic evidence are of little value for diagnostic purposes. Thus, many legionellosis cases remain unreported. A case of a woman with a medical history of acute myeloid leukaemia is presented. The patient suffered from repeated fever, and the early empirical treatment failed to relieve symptoms. Ultimately, she was diagnosed with Legionella pneumonia by metagenomic next-generation sequencing (mNGS). Moreover, a systematic review of the literature was performed using the Medline/PubMed databases. A search of the literature yielded 5 relevant articles, in which some clinical characteristics are reported, such as biological characteristics, epidemiological features, laboratory diagnosis, clinical findings and treatments. The review of the literature shows that accurate etiological diagnosis is becoming increasingly essential for definitive diagnosis and treatment strategies. Clinical manifestations of Legionnaires' disease are not specific, and many laboratory diagnostic tests have inherent weaknesses for the identification of Legionella. mNGS,  an indispensable approach for identifying microorganisms, can provide a promising tool for rapid and accurate etiological diagnosis methods contributing to early diagnosis and ultimately improving prognosis, especially for uncommon species such as Legionella pneumophila.