Abstract：
Penicillium marneffei is one of the most common opportunistic infectious fungi associated with AIDS (Acquired Immunodeficiency Syndrome). It is prevalent in Southeast Asia and southern China (such as Guangdong), but rare in inland provinces of China. Penicillium marneffei infections are often misdiagnosed.
Here, we report a patient with Penicillium marneffei infection from Shaanxi Province, China, who was previously repeatedly diagnosed as Kala-azar in two hospitals. The patient received medical treatment due to fever and multiple papules, worked as a tour guide, and had travel history in Southeast Asian countries. We performed nanopore genome sequencing on blood samples of the patient and obtained 84,000 reads in 3.5 hours. The average length of the sequences was 7088.7 bases and the longest sequence was 87471 bases. Through comparison with the pathogenic bacteria database, 13 homologous Penicillium marneffei sequences were identified. Furthermore, by using specific quantitative real time-polymerase chain reaction of Penicillium marneffei, fungal ITS (Internal Transcribed Spacer) sequencing, and fungal biphasic culture, we further confirmed the pathogen as Penicillium marneffei. Meanwhile, the patient was confirmed to be HIV (Human Immunodeficiency Virus) positive. Thus, the patient was diagnosed with AIDS combined with Penicillium marneffei infection, which, to the best of our knowledge, is the first report of Penicillium marneffei infection in Shaanxi Province, China.
Metagenomic analysis based on nanopore sequencing provides an important reference for the diagnosis of Penicillium marneffei infection in this case.
Here, we report a patient with Penicillium marneffei infection from Shaanxi Province, China, who was previously repeatedly diagnosed as Kala-azar in two hospitals. The patient received medical treatment due to fever and multiple papules, worked as a tour guide, and had travel history in Southeast Asian countries. We performed nanopore genome sequencing on blood samples of the patient and obtained 84,000 reads in 3.5 hours. The average length of the sequences was 7088.7 bases and the longest sequence was 87471 bases. Through comparison with the pathogenic bacteria database, 13 homologous Penicillium marneffei sequences were identified. Furthermore, by using specific quantitative real time-polymerase chain reaction of Penicillium marneffei, fungal ITS (Internal Transcribed Spacer) sequencing, and fungal biphasic culture, we further confirmed the pathogen as Penicillium marneffei. Meanwhile, the patient was confirmed to be HIV (Human Immunodeficiency Virus) positive. Thus, the patient was diagnosed with AIDS combined with Penicillium marneffei infection, which, to the best of our knowledge, is the first report of Penicillium marneffei infection in Shaanxi Province, China.
Metagenomic analysis based on nanopore sequencing provides an important reference for the diagnosis of Penicillium marneffei infection in this case.
摘要：
马尔尼菲青霉菌是与艾滋病（获得性免疫缺陷综合症）相关的最常见的机会性感染性真菌之一。它在东南亚和中国南部（如广东）盛行，但在中国内陆省份很少见。马尔尼菲青霉菌感染经常被误诊。
这里,我们报道了一名来自陕西省的马尔尼菲青霉菌感染患者，中国,他之前在两家医院多次被诊断为Kala-azar。病人因发烧及多发丘疹而接受药物治疗,当过导游,并有东南亚国家的旅行历史。我们对患者的血液样品进行了纳米孔基因组测序，并在3.5小时内获得了84,000个读数。序列的平均长度为7088.7个碱基,最长序列为87471个碱基。通过与病原菌数据库的比较,鉴定了13个同源马尔尼菲青霉菌序列。此外，通过使用马尔尼菲青霉菌的特异性定量实时聚合酶链反应，真菌ITS（内部转录间隔区）测序，和真菌双相培养，我们进一步确认病原体为马尔尼菲青霉菌。同时,患者被证实为HIV(人类免疫缺陷病毒)阳性.因此，患者被诊断为艾滋病合并马尔尼菲青霉菌感染，which,据我们所知,是陕西省首例马尔尼菲青霉菌感染报告,中国。
在这种情况下，基于纳米孔测序的宏基因组分析为诊断马尔尼菲青霉菌感染提供了重要参考。
这里,我们报道了一名来自陕西省的马尔尼菲青霉菌感染患者，中国,他之前在两家医院多次被诊断为Kala-azar。病人因发烧及多发丘疹而接受药物治疗,当过导游,并有东南亚国家的旅行历史。我们对患者的血液样品进行了纳米孔基因组测序，并在3.5小时内获得了84,000个读数。序列的平均长度为7088.7个碱基,最长序列为87471个碱基。通过与病原菌数据库的比较,鉴定了13个同源马尔尼菲青霉菌序列。此外，通过使用马尔尼菲青霉菌的特异性定量实时聚合酶链反应，真菌ITS（内部转录间隔区）测序，和真菌双相培养，我们进一步确认病原体为马尔尼菲青霉菌。同时,患者被证实为HIV(人类免疫缺陷病毒)阳性.因此，患者被诊断为艾滋病合并马尔尼菲青霉菌感染，which,据我们所知,是陕西省首例马尔尼菲青霉菌感染报告,中国。
在这种情况下，基于纳米孔测序的宏基因组分析为诊断马尔尼菲青霉菌感染提供了重要参考。
