human metagenome

Cutaneous granulomatosis is a kind of inflammatory reaction caused by various triggers including infections, foreign bodies, malignancies, chemicals, and so on. They can be divided into non-infectious and infectious granulomas due to different pathogenic factors. Here we report a child who presented with multiple invasive skin plaques accompanied by ulceration. Biopsies were performed successively and found tuberculous granuloma several times around. But no pathogen was found by special staining, tissue culture, or RT-PCR detection. Diagnostic quadrupled anti-mycobacterium therapy was also ineffective. Then NGS made a crucial discovery, rubella virus was founded and sequenced.