Mycobacterium avium complex and Cryptococcus neoformans co-infection in a patient with acquired immunodeficiency syndrome: a case report

Metagenomic next-generation sequencing assistance in identifying Mycobacterium avium meningoencephalitis: A case report and literature review

Nontuberculous mycobacteria associated intracranial infection is a rare disease that mainly occurs in HIV-infected patients. The disease has a poor prognosis. The authors report a case of non-tuberculous mycobacterial meningoencephalitis in a non-AIDS patient, but long history of poorly controlled type 2 diabetes mellitus. A 55-year-old, right-handed, male patient presented with an 8-day history of fever, episodes of severe headache with signs of meningeal irritation. MRI showed hyperintensities/contrast enhancement in the visual pathways, basal ganglia sellar region and leptomeninges. No etiological diagnosis was reached until metagenomic next-generation sequencing (mNGS) was used, showing the presence of Mycobacterium avium. The patient was cured with aggressive antimycobacterial therapy. The authors discuss the clinical manifestations and drug therapy of nontuberculous mycobacteria-related intracranial infections by reviewing relevant literature. As meningoencephalitis by Mycobacterium avium has a high mortality an early diagnosis and appropriate therapeutic interventions are warranted. For this reason, the use of mNGS can be helpful to avoid therapeutic delay.

Talaromyces amestolkiae Infection in an AIDS Patient with Cryptococcal Meningitis

Concurrent infections caused by multiple fungal pathogens in immunocompromised patients can pose diagnostic and treatment challenges. Here, we presented the first reported case in Taiwan of an AIDS patient who had concurrent infection with Cryptococcus neoformans meningitis and Talaromyces amestolkiae lymphadenopathy. The patient presented with an enlarged inguinal lymph node and was diagnosed with T. amestolkiae lymphadenitis. The species T. amestolkiae was identified using DNA sequencing, which had the capability of differentiating it from other Talaromyces species. The patient was discharged from the hospital following treatment with amphotericin B and subsequent administration of voriconazole. This case highlights the importance of maintaining a suspicion of co-infections and utilizing appropriate diagnostic tools, such as DNA sequencing, to identify possible pathogens. Further studies are needed to determine the optimal treatment for T. amestolkiae and other co-infecting fungal pathogens.

Versatile Applications of Cyanobacteria in Biotechnology

Cyanobacteria are blue-green Gram-negative and photosynthetic bacteria which are seen as one of the most morphologically numerous groups of prokaryotes. Because of their ability to fix gaseous nitrogen and carbon dioxide to organic materials, they are known to play important roles in the universal nutrient cycle. Cyanobacteria has emerged as one of the promising resources to combat the issues of global warming, disease outbreaks, nutrition insecurity, energy crises as well as persistent daily human population increases. Cyanobacteria possess significant levels of macro and micronutrient substances which facilitate the versatile popularity to be utilized as human food and protein supplements in many countries such as Asia. Cyanobacteria has been employed as a complementary dietary constituent of feed for poultry and as vitamin and protein supplement in aquatic lives. They are effectively used to deal with numerous tasks in various fields of biotechnology, such as agricultural (including aquaculture), industrial (food and dairy products), environmental (pollution control), biofuel (bioenergy) and pharmaceutical biotechnology (such as antimicrobial, anti-inflammatory, immunosuppressant, anticoagulant and antitumor); recently, the growing interest of applying them as biocatalysts has been observed as well. Cyanobacteria are known to generate a numerous variety of bioactive compounds. However, the versatile potential applications of cyanobacteria in biotechnology could be their significant growth rate and survival in severe environmental conditions due to their distinct and unique metabolic pathways as well as active defensive mechanisms. In this review, we elaborated on the versatile cyanobacteria applications in different areas of biotechnology. We also emphasized the factors that could impede the implementation to cyanobacteria applications in biotechnology and the execution of strategies to enhance their effective applications.