Case Report: identification of Scedosporium boydii combined with Mycobacterium avium complex in a patient with pulmonary infection based on metagenomic next-generation sequencing

There are hundreds of pathogens that cause lung infections, including a variety of rare and atypical pathogens, such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. Compared to infections caused by a single pathogen, mixed infections account for a larger proportion of pulmonary infections and have a more severe clinical presentation, while treatment options differ between the two. Identification of pathogens is the basis of diagnosis and treatment, however, the sensitivity and timeliness of traditional detection methods can no longer meet clinical requirements. On the contrary, since metagenomic next-generation sequencing (mNGS) technology does not rely on culture, it can rapidly diagnose all microorganisms in the sample, which is highly practical for patients with critical, unknown pathogens and mixed infections. In this study, we report the admission of a 79-year-old man with a mixed infection of Scedosporium boydii and Mycobacterium avium complex (MAC). To the best of our knowledge, this is the first patient in the world to be infected with these two atypical pathogens, which detected by mNGS.