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Application of NGS in Diagnosis of Tuberculous Pleurisy with Multiple Negative Tests: A Case Report

机译:NGS在多次负面测试中诊断结核性胸膜炎的应用 - 案例报告

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Background: Tuberculous pleurisy is inflammation caused by direct infection of Mycobacterium tuberculosis (MTB) and/or delayed allergic reaction of the pleura to MTB thallus components. The diagnosis of tuberculous pleurisy is mainly confirmed by bacterial culture, smear staining or histopathology, but has some clinical limitations. Next-generation sequencing (NGS), as a new diagnostic technology, has good application prospects in the diagnosis of tuberculous pleurisy. Case Presentation: A patient admitted with right pleural effusion and pneumonia was actively treated with anti-infection, anti-inflammatory and symptomatic support while various etiological tests of right pleural effusion were improved. However, all the etiological tests for MTB infection were negative. At this time, the patient’s condition worsened and pleural effusion also appeared on the left side. In order to clarify the cause of the disease as soon as possible and prevent the disease from worsening again, the left and right pleural effusions of the patient were sent for NGS testing. The test results suggested MTB infection, which finally clarified the diagnosis of tuberculous pleurisy, and the next treatment plan of the patient was timely adjusted. Conclusion: NGS is instructive in the diagnosis of tuberculous pleurisy when various conventional tests and imaging methods fail.
机译:背景:结核性葡素糖是由直接感染结核分枝杆菌(MTB)和/或延迟胸膜的过敏反应引起的炎症造成的炎症。结核性胸膜炎的诊断主要通过细菌培养,涂片染色或组织病理学来证实,但具有一些临床限制。作为一种新的诊断技术,下一代测序(NGS)具有良好的应用前景,诊断结核性胸膜。案例介绍:患有良好胸腔积液和肺炎的患者积极用抗感染,抗炎和症状载体治疗,而右胸腔积液的各种病因测试得到改善。然而,MTB感染的所有病因测试都是阴性的。此时,患者的状况恶化,左侧也出现了胸腔积液。为了尽快澄清疾病的原因并阻止疾病再次恶化,患者的左和右胸腔积液被送到NGS测试。测试结果表明MTB感染,最终澄清了结核性胸膜炎的诊断,并且及时调整了患者的下一个治疗计划。结论:当各种常规试验和成像方法发生故障时,NGS在结核性胸膜诊断中是有效的。

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