Pulmonary tuberculosis complicated by extensive and multiple ground-glass opacity diagnosed by metagenomic next-generation sequencing in a patient with normal immune function: A case report

Abstract

A 53-year-old immune-competent female presented with atypical pulmonary tuberculosis (PTB) imaging complicated by extensive and multiple clear boundary ground-glass opacity (GGO) in both lungs. Conventional diagnostic methods for infectious or non-infectious causes failed to identify the etiology. To further detect the accurate pathogen, bronchoalveolar lavage fluid (BALF) was collected for metagenomic next-generation sequencing (mNGS). Mycobacterium tuberculosis was identified by mNGS, thus the patient was diagnosed with PTB. The GGO lesions were healed after the patient received anti-tuberculosis treatment. In a follow-up after 3 months, the patient’s GGO lesion vanished. Based on these results, we for the first time reported a case of PTB in an immune-competent patient complicated by extensive and multiple GGO. And we found that mNGS was a useful complement to conventional pathogenic diagnostic methods and can be used to diagnose infections of unknown cause.