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BackgroundMetagenomic sequencing has shown tremendous promise in solving difficult infectious diseases cases. In this study, we utilized this technology to help guide the care of a critically ill patient with severe pneumonia, fever of unknown origin, and subsequent encephalitis in the intensive care unit (ICU).MethodsShotgun metagenomic sequencing was performed on the patient's blood, bronchoalveolar lavage (BAL), and cerebral spinal fluid by using an Illumina MiniSeq sequencer.ResultsA high load of human adenovirus B55 (HAdV-B55), a highly pathogenic adenovirus associated with numerous recently reported outbreaks and deaths in China, was detected in both blood and BAL, which explained the severity of the condition. The patient was treated with intravenous ribavirin, which cleared the virus after 26 days. Metagenomic sequencing also helped diagnose an unexpected herpes simplex virus-1 encephalitis during hospitalization, which led to timely treatment.ConclusionsThis was the first successful case utilizing metagenomic sequencing to guide diagnosis and treatment in the ICU setting in China. We have proven the concept that metagenomic sequencing can play an important role in determining clinical approaches and ultimately in improving patient outcomes. We also hope to share our successful treatment protocol for the severe pneumonia and viremia caused by HAdV-B55.

Viral reactivation is widespread in patients with severe pneumonia, yet the landscape of viral reactivation in the lungs is not well‐known. This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next‐generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia. Cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and Epstein‐Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052‐fold increase in 28‐day all‐cause mortality (95% CI: 1.004–4.194). This study showed that CMV, HSV‐1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials. [ABSTRACT FROM AUTHOR]

The CTAB-templated Fe2O3-SiO2 nano-composite films with different concentrations of cetyltrimethylammonium bromide (CTAB) were prepared by sol-gel method using TEOS and Fe (NO3)3·9H2O as precursors, and surfactant CTAB is used as a template. Raman spectra indicated the α phase of the Fe2O3 exist in the composites films. The transparency of the CTAB-templated Fe2O3-SiO2 nano-composite films is related to the content of CTAB, the number of layers. The all CTAB-templated Fe2O3-SiO2 nano-composite films are optically transparent in the 500–2100 nm range in the condition of the experiment. A red shift of the absorption edge of the CTAB-templated Fe2O3-SiO2 nano-composite films is observed with concentrations of Fe2O3 increased. [ABSTRACT FROM PUBLISHER]

Fe2O3/SiO2 nano-composite films were prepared by sol-gel technique combining heat treatment in the range of 100–900 °C. The particle size was observed by FE-SEM. Optical properties of the films were investigated by UV-visible spectra. Structural and magnetic characteristics were investigated through FT-IR and VSM. The transparency of the Fe2O3/SiO2 nano-composite films decreased with the content of the Fe2O3. Water and organic solvent in the films were evaporated with heat treatment, so the transparency of the films was enhanced under high temperature. It is also found that the saturation magnetization ( Ms) of the films increases with the temperature. As the content of the Fe2O3 increases, when the content of the Fe2O3 is around 30wt%, the Ms of the films has a maximum value. [ABSTRACT FROM AUTHOR]

Adult-onset immunodeficiency (AOID) mediated by anti-interferon-γ autoantibodies (AIGA) is a rare condition, particularly prevalent in Southeast Asia and southern China. We present a case study of a 62-year-old female with AOID who developed a severe pulmonary infection caused by Talaromyces marneffei (TM), leading to acute respiratory failure, generalized rash, multiple lymphadenopathies, bone destruction, and a mediastinal mass. Treatment included mechanical ventilation, antifungal medication, and corticosteroids, resulting in complete recovery and discharge. This case underscores the challenges of managing complex infections in AOID patients and highlights the importance of early diagnosis through metagenomic next-generation sequencing (mNGS) and appropriate intervention to improve clinical outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Li, Zhang, Zhang, Chen and Fang.)