Fatal multiple organ dysfunction caused by commensal bacteria of urogenital tract infection in adult lung transplant recipients: two case reports

Abstract

Background Infection following lung transplantation has been the focus of clinical concerns. The colonization rate of commensal bacteria of the urogenital tract, including Mycoplasma hominis, Ureaplasma urealyticum (UU), and herpes simplex virus type-2 (HSV-2), is high, which may cause secondary infection after transplantation. Case presentation Twenty-three-year-old and 67-year-old women underwent lung transplantation for different causes. Shortly after the operation, they developed perineal skin ulcers, hypoxia, and intractable epilepsy. Subsequent computed tomography (CT) of the chest showed lung consolidation, and cranial CT showed shallowing sulci and gyri. UU and HSV-2 were detected in bronchoalveolar lavage fluid by next-generation sequencing, and HSV-2 was shown in the cerebrospinal fluid of both patients. Despite active treatment, both suffered irreversible brain function damage within 72 h of the seizure. Conclusions Clinicians should know that commensal bacteria of urogenital tract infections can lead to fatal multiple organ dysfunction after lung transplantation.

Applicability of Bronchoalveolar Lavage Fluid and Plasma Metagenomic Next-Generation Sequencing Assays in the Diagnosis of Pneumonia

“…BALF and plasma mNGS tests were performed in our clinical laboratory to detect both DNA and RNA pathogens. Our recent studies provide a comprehensive description of the analytical and clinical validation of tests, as well as the experimental procedures (eg, sample processing, nucleic acid extraction, library construction, high-throughput sequencing, and bioinformatics analysis), reagents, controls, sequencers, software, and algorithms involved in each step [ 2 , 13 , 14 , 18 , 19 ]. The detected pathogens and the number of sequencing reads (stringent mapped read number [SMRN], referring to the number of reads per pathogen at the sequencing depth of 20 million reads) are sent to the clinical treating team from the clinical laboratory [ 2 ].…”

Evaluation of a multiplex Real-time PCR kit for simultaneous diagnosis of Ureaplasma urealyticum and Ureaplasma parvum

“…Although Ureaplasma colonization usually presents no health risks, these species can cause urogenital infections and are often implicated in infertility, preterm birth, and other adverse pregnancy outcomes [3,4,5,6]. Recent evidence has linked UU/UP with extra-genitourinary infections, such as septic arthritis in immunocompromised patients [7,8,9,10], and post-transplantation infections in transplant patients [11,12,13]. Cases of hyperammonemia syndrome (HS) caused by UU or UP have resulted in fatalities, raising concerns due to the high mortality rate once HS has occurred [14].…”