Metagenomic Next-Generation Sequencing Technique Helps Identify Cryptococcal Infection in the Rib

Case: Two patients presented with pathological lytic bone lesions in the rib and associated soft tissue mass believed initially to represent soft tissue neoplasm. However, further consideration of infectious etiologies led to the identification of cryptococcal osteomyelitis. In one case, the microbiological culture was negative, but Cryptococcus neoformans was identified with the help of the metagenomic next-generation sequencing (mNGS) technique. Both patients received oral fluconazole-only treatment, and the infections were successfully eradicated. Conclusions: The mNGS technique helps identify cryptococcal infection in the rib.