Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3284
Peer-review started: November 23, 2021
First decision: January 11, 2022
Revised: February 4, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 125 Days and 21.2 Hours
With the increasing prevalence of human immunodeficiency virus (HIV), the incidence of Mycobacterium tuberculosis (M. tuberculosis) bacteremia has also increased. As a common affliction of acquired immunodeficiency syndrome patients, M. tuberculosis infection is associated in these patients with severe sepsis and high mortality. In contrast, M. tuberculosis bacteremia is rarely seen in HIV-negative patients, and M. tuberculosis has never been reported from the blood of patients with liver cirrhosis.
We evaluated a 55-year-old Chinese male patient who had been admitted to the hospital with abdominal distension of unknown cause of one-week duration, accompanied by diarrhea, shortness of breath, and occasional fever. Based on these indicators of abnormal inflammation and fever, we suspected the presence of an infection. Although evidence of microbial infection was not found in routine clinical tests and the patient did not show typical clinical symptoms of infection with M. tuberculosis, next-generation sequencing of blood samples nevertheless demonstrated the presence of M. tuberculosis, which was subsequently isolated from blood samples grown in conventional BacT/ALERT FA blood culture bottles.
Our findings demonstrate that HIV-negative liver cirrhosis patients can also be infected with M. tuberculosis.
Core Tip: Our findings are interesting in two ways. First, although Mycobacterium tuberculosis (M. tuberculosis) bacteremia is a common occurrence in acquired immunodeficiency syndrome patients, it has rarely been reported from human immunodeficiency virus (HIV)-negative patients. We report here, however, a case of M. tuberculosis bacteremia in an HIV-negative patient diagnosed with liver cirrhosis. This finding should alert physicians to consider the possibility of M. tuberculosis bacteremia in patient populations not usually considered to be vulnerable to such infections. Second, our successful use of next-generation sequencing for detection of M. tuberculosis in the blood should be of interest to physicians as a tool for early detection of microbial infection.