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Arthritis caused by Legionella micdadei and Staphylococcus aureus: metagenomic next-generation sequencing provides a rapid and accurate access to diagnosis and surveillance.
Ann Transl Med 2019; 7(20):589AT

Abstract

Legionella spp. is an important pulmonary pathogen but rarely causes extra-pulmonary infections. We report a case of joint infection caused by Legionella micdadei and Staphylococcus aureus in a 54-year-old male with medication history of oral steroid for systemic lupus erythematosus (SLE). He developed arthritis in his right metacarpophalangeal (MCP) joints without precursor pneumonia. In the joint aspirate, S. aureus was detected through culture. The existence of L. micdadei and S. aureus were indicated by metagenomic next-generation sequencing (mNGS) and confirmed by 16S rRNA sequence analysis. After oral levofloxacin treatment for 54 days, the patient's symptoms ameliorated and blood test results improved, which were consistent with the dynamic trend of reads numbers in mNGS data. Our case included, arthritis caused by Legionella spp. have been reported in 11 patients. However, our case is the first to report septic arthritis caused by L. micdadei in native joints and monitored by mNGS. This case demonstrated an application of mNGS for etiological diagnosis and semi-quantification in joint aspirate. mNGS may serve as a promising tool for rapid and accurate etiological diagnosis and surveillance, contributing to appropriate antimicrobial drug applications and timely medication adjustments when necessary.

Authors+Show Affiliations

Department of infectious diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.Department of infectious diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.Department of infectious diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.Department of infectious diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.Department of infectious diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin 300308, China.Wuhan research and development of infectious diseases department, BGI-Wuhan, Wuhan 430075, China.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31807570

Citation

Huang, Yingnan, et al. "Arthritis Caused By Legionella Micdadei and Staphylococcus Aureus: Metagenomic Next-generation Sequencing Provides a Rapid and Accurate Access to Diagnosis and Surveillance." Annals of Translational Medicine, vol. 7, no. 20, 2019, p. 589.
Huang Y, Ma Y, Miao Q, et al. Arthritis caused by Legionella micdadei and Staphylococcus aureus: metagenomic next-generation sequencing provides a rapid and accurate access to diagnosis and surveillance. Ann Transl Med. 2019;7(20):589.
Huang, Y., Ma, Y., Miao, Q., Pan, J., Hu, B., Gong, Y., & Lin, Y. (2019). Arthritis caused by Legionella micdadei and Staphylococcus aureus: metagenomic next-generation sequencing provides a rapid and accurate access to diagnosis and surveillance. Annals of Translational Medicine, 7(20), p. 589. doi:10.21037/atm.2019.09.81.
Huang Y, et al. Arthritis Caused By Legionella Micdadei and Staphylococcus Aureus: Metagenomic Next-generation Sequencing Provides a Rapid and Accurate Access to Diagnosis and Surveillance. Ann Transl Med. 2019;7(20):589. PubMed PMID: 31807570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthritis caused by Legionella micdadei and Staphylococcus aureus: metagenomic next-generation sequencing provides a rapid and accurate access to diagnosis and surveillance. AU - Huang,Yingnan, AU - Ma,Yuyan, AU - Miao,Qing, AU - Pan,Jue, AU - Hu,Bijie, AU - Gong,Yanping, AU - Lin,Yang, PY - 2019/12/7/entrez KW - Arthritis KW - high-throughput nucleotide sequencing KW - legionella SP - 589 EP - 589 JF - Annals of translational medicine JO - Ann Transl Med VL - 7 IS - 20 N2 - Legionella spp. is an important pulmonary pathogen but rarely causes extra-pulmonary infections. We report a case of joint infection caused by Legionella micdadei and Staphylococcus aureus in a 54-year-old male with medication history of oral steroid for systemic lupus erythematosus (SLE). He developed arthritis in his right metacarpophalangeal (MCP) joints without precursor pneumonia. In the joint aspirate, S. aureus was detected through culture. The existence of L. micdadei and S. aureus were indicated by metagenomic next-generation sequencing (mNGS) and confirmed by 16S rRNA sequence analysis. After oral levofloxacin treatment for 54 days, the patient's symptoms ameliorated and blood test results improved, which were consistent with the dynamic trend of reads numbers in mNGS data. Our case included, arthritis caused by Legionella spp. have been reported in 11 patients. However, our case is the first to report septic arthritis caused by L. micdadei in native joints and monitored by mNGS. This case demonstrated an application of mNGS for etiological diagnosis and semi-quantification in joint aspirate. mNGS may serve as a promising tool for rapid and accurate etiological diagnosis and surveillance, contributing to appropriate antimicrobial drug applications and timely medication adjustments when necessary. SN - 2305-5839 UR - https://www.unboundmedicine.com/medline/citation/31807570/Arthritis_caused_by_Legionella_micdadei_and_Staphylococcus_aureus:_metagenomic_next-generation_sequencing_provides_a_rapid_and_accurate_access_to_diagnosis_and_surveillance DB - PRIME DP - Unbound Medicine ER -
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