Diagnosis of osteoarticular tuberculosis via metagenomic next‑generation sequencing: A case report

Huang,Zida; Zhang,Chongjing; Hu,Deqing; Shi,Kai; Li,Wenbo; Zhang,Chaofan; Li,Mengqing; Wang,Qijin; Wu,Qiqiao; Yang,Bin; Li,Xing; Huayong,Liu; Xifang,Nie; Zhang,Wenming

doi:10.3892/etm.2019.7655

Diagnosis of osteoarticular tuberculosis via metagenomic next‑generation sequencing: A case report

Authors:
- Zida Huang
- Chongjing Zhang
- Deqing Hu
- Kai Shi
- Wenbo Li
- Chaofan Zhang
- Mengqing Li
- Qijin Wang
- Qiqiao Wu
- Bin Yang
- Xing Li
- Liu Huayong
- Nie Xifang
- Wenming Zhang
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Affiliations: Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350004, P.R. China, BGI Genomics, BGI‑Shenzhen, Shenzhen, Guangdong 518083, P.R. China
Published online on: June 10, 2019 https://doi.org/10.3892/etm.2019.7655
Pages: 1184-1188
Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Osteoarticular tuberculosis (OAT) may cause severe complications and disability. Due to its indolent nature, OAT is difficult to diagnose in the early stages. Diagnosis by conventional culture is time‑consuming and insensitive, and polymerase chain reaction‑based molecular diagnostic methods are incapable of excluding co‑infections. Metagenomic next‑generation sequencing (mNGS) may identify a broad spectrum of microorganisms, including Mycobacterium, bacteria and fungi, in clinical specimens. Therefore, the diagnosis of OAT may be rapidly performed using mNGS. The present study reports on a case of OAT. The patient presented with right knee swelling and pain for 1 year; his C‑reactive protein levels and erythrocyte sedimentation rate were markedly elevated. Although multiple pre‑operative cultures were negative, mNGS was finally used to successfully detect the underlying pathogen. The result was confirmed by other molecular biology methods and Mycobacterium culture. Anti‑tuberculosis therapy was administered accordingly and the patient finally recovered. In conclusion mNGS, with the ability to detect Mycobacterium and other microorganisms in a single assay, is an emerging approach for rapidly and accurately diagnosing OAT. This method may provide significant support to guide physicians in selecting the appropriate pharmacotherapy and surgical treatments.

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