METHODS: A 24-years-old male patient presented with chronic non-productive cough of 4 months duration. He had been diagnosed with Mycobacterium tuberculosis infection and lung malignancy elsewhere and presented to us as the symptoms persisted. We offered him the biopsy under endobronchial ultrasound-guide sheath-transbronchial lung biopsy and sample specimen were sent for next generation sequencing analysis, returned as Blastomyces Dermatitidis infection. The patient was treated by itraconazole for 6 months, his symptoms decreased significantly and the CT scan showed resolution of the lesion.
CONCLUSIONS: We shared a case of blastomycosis with delayed and difficult diagnosis and reviewed the knowledge regarding differential diagnosis and next generation sequencing technologies.
方法:一名24岁男性患者表现为4个月的慢性非生产性咳嗽。他在其他地方被诊断出患有结核分枝杆菌感染和肺部恶性肿瘤,并在症状持续存在时向我们介绍。我们为他提供了支气管内超声引导鞘-经支气管肺活检的活检,并将样本标本送去进行下一代测序分析,作为皮肤芽胞菌感染返回。患者接受伊曲康唑治疗6个月,症状明显减轻,CT扫描显示病灶消退.
结论:我们分享了一例诊断延迟和困难的芽生菌病,并回顾了有关鉴别诊断和下一代测序技术的知识。