PMC9386609_01
The chest images of this patient. The CT scan showed diffused effusion and GGO in both lungs.
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The computed tomography (CT) scan showed diffused effusion and ground glass opacity (GGO) in both lungs (Figure 1).
The bone marrow biopsy result of the patient. Hemophagocyte was detected in bone marrow smear.
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The results revealed that the hemophagocyte was detected in the smear (Figure 2).
The results of mNGS and qPCR: (a) coverage and reads number of detected P. jirovecii by BALF-mNGS on December 28th, (b) coverage and reads number of detected P. jirovecii by blood-mNGS on December 28th, and (c) qPCR results of mtSSU region of P. jirovecii, four out of the eight samples were positive.
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Gram stain of the BALF revealed many Gram-negative organisms. mNGS revealed P. jirovecii in both serum and BALF with reads per million (RPM) of 17 and 437 (Figure 3), while other diagnostic tests did not detect any pathogenic microorganism. The mtSSU region of P. jirovecii was subsequently detected by qPCR using the same samples (Figure 3).
Change of P. jirovecii DNA reads in BALF and serum. During the 21-day treatment, the DNA reads of P. jirovecii by mNGS using both serum and BALF disclosed a dramatic increase since the medication of TMP/SMX, then declined gradually.
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During the 21-day treatment, the DNA reads of P. jirovecii by mNGS using both serum and BALF disclosed a dramatic increase since the medication of TMP/SMX, then declined gradually (Figure 4).