A Case Report of Tuberculous Peritonitis with Negative GeneXpert and Positive Metagenomic Sequencing Results

Jinjin Yan,1 Huilin Yang,1 Wei Zhang,1 Yu Li,1 Xue Yu,2 Zibo Xiong,3 Chenyan Shi,2 Yunlong Hu2 1Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, 518036, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Infection Immunity and Inflammation, Department of Pathogen Biology, School of Medicine, Shenzhen University Medical School, Shenzhen, 518055, People’s Republic of China; 3Department of Nephrology, Peking University Shenzhen Hospital, Shenzhen, 518036, People’s Republic of ChinaCorrespondence: Yunlong Hu, Email huyunlong@szu.edu.cn Chenyan Shi, Email shichenyan9@gmail.comAbstract: A 65-year-old male patient undergoing peritoneal dialysis was diagnosed with Mycobacterium tuberculosis-related peritonitis. Initial diagnostic tests, including acid-fast smear of ascites, GeneXpert test, and Mycobacterium tuberculosis culture, yielded negative results. However, metagenomic capture sequencing (metaCAP) and metagenomic next-generation sequencing (mNGS) identified the presence of Mycobacterium tuberculosis. The patient was subsequently treated with standard anti-tuberculosis therapy, leading to clinical improvement. This case highlights the utility of advanced molecular diagnostics in identifying atypical pathogens in peritoneal dialysis-related infections.Keywords: tuberculous peritonitis, Mycobacterium tuberculosis, next-generation sequencing, GeneXpert