Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2023; 11(3): 709-718
Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.709
Soft tissue tuberculosis detected by next-generation sequencing: A case report and review of literature
Yan-Gai He, Ya-Hui Huang, Xiao-Lan Yi, Kao-Liang Qian, Ying Wang, Hui Cheng, Jun Hu, Yuan Liu
Yan-Gai He, Ya-Hui Huang, Xiao-Lan Yi, Ying Wang, Yuan Liu, Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Kao-Liang Qian, Hui Cheng, Jun Hu, Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: He YG and Huang YH drafted the manuscript, interpreted the patient data. Xi XL, Qian KL, Wang Y, and Cheng H collected information from the patients and searched the related literature. Liu Y and Hu J contributed to supervision and final approval. All authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82272544.
Informed consent statement: Informed written consent was obtained from the patient and his family for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan Liu, MD, PhD, Academic Research, Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. liuyuan@jsph.org.cn
Received: November 26, 2022
Peer-review started: November 26, 2022
First decision: December 13, 2022
Revised: December 21, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: January 26, 2023
Processing time: 61 Days and 1.5 Hours
Abstract
BACKGROUND

Soft tissue tuberculosis is rare and insidious, with most patients presenting with a localized enlarged mass or swelling, which may be factors associated with delayed diagnosis and treatment. In recent years, next-generation sequencing has rapidly evolved and has been successfully applied to numerous areas of basic and clinical research. A literature search revealed that the use of next-generation sequencing in the diagnosis of soft tissue tuberculosis has been rarely reported.

CASE SUMMARY

A 44-year-old man presented with recurrent swelling and ulcers on the left thigh. Magnetic resonance imaging suggested a soft tissue abscess. The lesion was surgically removed and tissue biopsy and culture were performed; however, no organism growth was detected. Finally, Mycobacterium tuberculosis was confirmed as the pathogen responsible for infection through next-generation sequencing analysis of the surgical specimen. The patient received a standardized anti-tuberculosis treatment and showed clinical improvement. We also performed a literature review on soft tissue tuberculosis using studies published in the past 10 years.

CONCLUSION

This case highlights the importance of next-generation sequencing for the early diagnosis of soft tissue tuberculosis, which can provide guidance for clinical treatment and improve prognosis.

Keywords: Mycobacterium tuberculosis; Soft tissue infection; Next-generation sequencing; Extrapulmonary tuberculosis; Diagnosis; Case report

Core Tip: The diagnosis of extrapulmonary tuberculosis can be challenging, especially for tuberculosis in rare sites such as soft tissues. Soft tissue tuberculosis is rare and easily misdiagnosed. A delay in soft tissue tuberculosis diagnosis may worsen the disease, increase tuberculosis transmission, and accelerate the evolution of drug resistance. This case report emphasizes the importance of next-generation sequencing for early diagnosis of soft tissue tuberculosis, which can provide guidance for clinical treatment and improve prognosis.