case_images: PMC10787303_01
case_images: CT scan of the patient chest.
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case_images: Re-examination of chest and abdominal CT (Figure 1) revealed bilateral lung infections, bilateral pleural effusions, abnormal shadows in bilateral scrotum and inguinal regions, calcification in the aortic wall and coronary wall, multiple stones in the right kidney, and suspected hyperplasia in the left adrenal gland.
case_images: Results of mNGS using scrotal fluid and blood. (a-d) The genome coverage of detected P. distasonis, L. massiliensis, B. thetaiotaomicron, and E. faecalis by mNGS using scrotal fluid was 3.61, 6.75, 4.76, and 0.68%, respectively. (e and f) The detected specific reads number and the percentage of each pathogen by mNGS using scrotal fluid and blood in this patient. (g and h) The genome coverage of detected P. distasonis, L. massiliensis, and B. thetaiotaomicron by mNGS using blood was 0.07, 0.04 and 0.03%, respectively.
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case_images: P. distasonis, and E. faecalis (Figure 2a-i). Polymerase chain reaction (PCR) using scrotal effusion confirmed the mNGS detection, while blood PCR only detected L. massiliensis (Figure 3).
case_images: PCR results of L. massiliensis, B. thetaiotaomicron, and P. distasonis using hydrocele and blood in this patient. L. massiliensis was positive in both hydrocele and blood. B. thetaiotaomicron and P. distasonis were positive in hydrocele but negative in blood. The PCR amplification primers (target 16S) for B. thetaiotaomicron were 5'-GCAAACTGGAGATGGCGA-3' (Forward) and 5'-AAGGTTTGGTGAGCCGTTA-3' (Reverse) with amplified fragment of 197 bp. The PCR amplification primers (target 16S) for P. distasonis were 5'-AATACCGCATGAAGCAGG-3' (Forward) and 5'-GACACGTCCCGCACTTTA-3' (Reverse) with amplified fragment of 301 bp. The PCR amplification primers (target 16S) for L. massiliensis were 5'-TAGGTGTCGGGTGTCAAAGC-3' (Forward) and 5'-CCTGGTAAGGTTCTTCGCGT-3' (Reverse) with amplified fragment of 159 bp. PCR amplification conditions were 94C, 5 min; 40 cycles (94C, 30 s; 53C, 30 s; 72C, 30 s); 72C, 5 min. NTC in the image refers to no template control.
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case_images: P. distasonis, and E. faecalis (Figure 2a-i). Polymerase chain reaction (PCR) using scrotal effusion confirmed the mNGS detection, while blood PCR only detected L. massiliensis (Figure 3).
case_images: Progression diagram of the patient's condition.
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case_images: The patient's symptoms gradually improved (Figure 4).