The mNGS result of the first BALF sample (the second day) and the second BALF sample (the ninth day).

The patient we reported was finally diagnosed with endobronchial tuberculosis after two mNGS of BALF, narrowing of the opening of the left upper lobe bronchusand under fiberoptic bronchoscope and chest CT scans. BALF specimen was directly sent to Clinical Genome Center, Guangxi Kingmed Diagnostics, for mNGS via Illumina platform. The methods of mNGS were the same as that described in previously published mNGS articles(1, 2). The mNGS result of the first BALF indicated 1091, 267 and one sequence readings of Haemophilus influenzae, Streptococcus pneumoniae and MTB, with coverage of 11.16%, 2.45%, 0.001577% respectively. And two sequences of MTB were detected by the mNGS of the second BALF with a coverage of 1.Shi Y, Chen J, Shi X, Hu J, Li H, Li X, et al. A case of chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review. BMC infectious diseases. 2021; 21:621. 2. Qin Z, Zou Y, Huang Z, Yu N, Deng Z, Chen Z, et al. Metagenomic next-generation sequencing contributes to the diagnosis of mixed pulmonary infection: a case report. Annals of clinical microbiology and antimicrobials. 2022; 21:52.