AUTHOR=Zhang Qing , Liu Xingchen , Liu Yanyan , Wang Huiqin , Zhao Ran , Lv Xiaodong , Wei Xudong , Zhou KeShu 

TITLE=Nasal and cutaneous mucormycosis in two patients with lymphoma after chemotherapy and target therapy: Early detection by metagenomic next-generation sequencing

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.2022.960766

DOI=10.3389/fcimb.2022.960766

ISSN=2235-2988

ABSTRACT=Mucormycosis is a conditionally pathogenic fungal disease with high morbidity that mainly affects patients with decreased immunity. Diagnosis relies on histopathological examination of microorganisms with the typical structure of mucormycetes in tissues, and subsequent confirmation via culture. Early detection of causative microorganisms is critical to rapidly administer appropriately targeted antibiotics. Metagenomic next-generation sequencing (mNGS) is an innovative and sensitive technique used to identify pathogenic strains. Here, we used mNGS to timely diagnose infection with Lichtheimia ramosa and Mucor irregularis in two patients with hematologic malignancies; infections manifested as nasal and cutaneous infections, and developed after chemotherapy and small molecule targeted therapy. Following treatment with amphotericin B cholesteryl sulfate complex, symptoms reduced significantly, and both patients obtained successful outcomes. Additionally, we searched and summarized current medical literature on the successful diagnosis of mucormycosis using mNGS. These cases indicated that mNGS, a novel culture-independent method, is capable of rapid, sensitive, and accurate identification of pathogens. mNGS may be a complementary method for early identification of mucormycosis, allowing for appropriate and timely antibiotic administration, thus improving patient outcomes.