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Table 1 Clinical information, Laboratory Procedures and Results

From: Direct-from-blood RNA sequencing identifies the cause of post-bronchoscopy fever

Demographics

 

22 year old Caucasian female

Symptoms

 

fevers, chills, nausea, poor appetite

Vital signs

Blood pressure:

107/57

Heart Rate:

124

Respiratory rate:

22

Oxygen saturation:

96% room air

Physical Exam

Lung:

mild wheeze and scattered crackles

otherwise, unremarkable

 

Laboratory analysis

WBC:

13.2

Hemoglobin:

8.5

Platelets:

279

Sodium:

137

Potassium:

4.8

BUN:

14

Creatinine:

1.2

Glucose:

289

Lactate:

4.2

Thyroid Panel*:

Within normal limits

ESR & CRP:

within normal limits

ANA Screen*:

Negative

Microbiology

Blood Culture:

no growth

Urine Culture:

no growth

BAL Culture:

rare Mucoid Pseudomonas

 

rare MRSA

 

Aspergillus flavus present

CMV quantitative PCR*:

undetectable

EBV quantitative PCR*:

undetectable

Pathology

BAL biopsy:

no evidence of rejection or infection

Radiology

Chest X-ray:

right lower lobe atelectasis

CT scan chest:

Interval development of ground glass and dense airspace

 

opacities in the lateral basal segment of the right lower

 

lobe. Recent bronchoscopy with biopsy in this location.

Nasopharyngeal Swab

Collected using the BD Universal Transport System from BD Biosciences using routine procedures and analyzed by multiplex PCR (xTAG® Respiratory Viral Panel FAST v2)

RNA Sequencing

Total RNA was isolated from 2.5 mL of peripheral blood drawn directly into PAXgene Blood RNA stabilization tubes (BD Biosciences) using the PAXgene Blood miRNA Kit (Qiagen). Abundant Globin and ribosomal RNA transcripts were depleted using Globin-Zero Gold rRNA Removal Kit (Illumina, San Diego, CA, USA). RNA sequencing library preparation used NEBNext Ultra RNA Library Prep Kit for Illumina (NEB, Ipswich, MA, USA). The resulting library was sequenced on the Illumina HiSeq 4000 to produce at least 50 million reads in a 2X 150 bp paired end format. Sequences were deposited in the Sequence Read Archive under project PRJNA408161.

  1. *indicates test was done within 1 month of enrollment. All other tests were done at the time of enrollment or are the results of the BAL done the prior day
  2. WBC = white blood count, BUN = blood urea nitrogen, ESR = erythrocyte sedimentation rate, CRP = c-reactive protein, ANA = anti-nuclear antibody, BAL = bronchoalveolar lavage, CMV = Cytomegalovirus, EBV = Epstein Barr virus
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BMC Infectious Diseases

ISSN: 1471-2334

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