Metagenomic Next-Generation Sequencing of Mycoplasma hominis Infection in an Immunocompromised Patient: A Case Report.
Jiajing Li, Weijie Zhou, Lingmin Cai et al.
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Case in brief
A 52-year-old immunocompromised man developed persistent soft-tissue infection after a wooden splinter injury, with recurrent fever, wound pain, swelling, and exudation. Empirical ertapenem and surgery did not produce sustained improvement, and conventional microbiological investigations were inconclusive. Blood metagenomic next-generation sequencing detected Mycoplasma hominis, alongside human betaherpesvirus 5 and GB virus C; the M. hominis result was assessed in the context of the clinical course and lack of a convincing alternative bacterial pathogen. After further surgical management and multidisciplinary evaluation, intravenous moxifloxacin plus omadacycline, followed by oral omadacycline, was associated with clinical improvement and declining inflammatory markers.
What made this case unusual
The pathogen was identified by blood mNGS despite only nine species-specific M. hominis reads, in a culture-negative, treatment-refractory soft-tissue infection after a splinter injury.
Diagnostic / clinical pearl
Interpret low-read mNGS findings alongside the clinical picture, conventional microbiology, and treatment response; a sequencing result alone should not establish the diagnosis.