ArticleScientific reports2025
The value of metagenomic next-generation sequencing in the diagnosis of fever of unknown origin.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- The diagnostic and therapeutic value of FDG PET/CT for infectious diseases in FUO/IUO patients.Annals of nuclear medicine · 2026Article
- Review
- Clinical efficacy of plasma cell-free DNA metagenomic next-generation sequencing in diagnosing bloodstream infections.BMC infectious diseases · 2026Article
- Fungal diagnostic stewardship in immunocompromised populations: a focus on molds and dimorphic fungi.Clinical microbiology reviews · 2026Review
- Institutional Readiness and Diagnostic Challenges for the Management of Pyrexia of Unknown Origin (PUO) in Nepal: A Mixed-Methods Study at Tertiary Level Hospitals.Research square · 2026Article
- Balancing Empirical Treatment and Comprehensive Evaluation in a Case of Suspected Rickettsial Infection: A Diagnostic Dilemma in Recurrent Fever.The American journal of case reports · 2025Article
- Metagenomic Next-Generation Sequencing in Infectious Diseases: Clinical Applications, Translational Challenges, and Future Directions.Diagnostics (Basel, Switzerland) · 2025Review
- Clinical utility of metagenomic next-generation sequencing in pathogen detection for lower respiratory tract infections.Scientific reports · 2025Article
- Analysis of the characteristics of mixed infections with Mycoplasma pneumoniae in children.Scientific reports · 2025Article
- Development and performance evaluation of a clinical metagenomics approach for identifying pathogens in the whole blood from patients with undifferentiated fever.Frontiers in cellular and infection microbiology · 2025Article
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6 authors.
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Abstract
Fever of unknown origin (FUO) caused by infection is a disease state characterized by complex pathogens and remains a diagnostic dilemma. Metagenomic next-generation sequencing (mNGS) technology is a promising diagnostic tool for identifying pathogenic microbes of FUO caused by infection. Little is known about the clinical impact of mNGS in the etiological diagnosis of FUO. This study focuses on the value of mNGS in the etiologic diagnosis of FUO by diagnostic performance, further clarifying the value of mNGS in clinical management. In a single-centre retrospective cohort study, 263 FUO patients who underwent both mNGS and culture at the First Affiliated Hospital of Nanchang University were enrolled from December 2020 to February 2023. The sensitivity and specificity of culture and mNGS were analyzed based on the final clinical diagnosis as the gold standard to assess the diagnostic value of mNGS in FUO cases. Among the 263 patients, 69.96%(184/263) cases were diagnosed as infectious diseases, of which lower respiratory tract infections were the most common, accounting for 53.26%(98/184). 30.04%(79/263) cases had a diagnosis of non-infectious disease. From these cases, mNGS identified 150 true-positive cases, 21 false-positive cases, 58 true-negative cases, and 34 false-negative cases. The sensitivity of mNGS in infection diagnosis was much higher than that of culture [81.52%(150/184) vs. 47.28%(87/184)], but the specificity was the opposite[73.42%(58/79) vs. 84.81%(67/79)]. mNGS had a receiver operating characteristic (ROC) curve of 0.775 for infectious disease, which was significantly higher than that of culture (0.661, P < 0.05). mNGS detection revealed that bacteria were the most commonly identified potential pathogens. The top causative pathogens identified were Acinetobacter baumannii. Of the 263 patients with FUO, clinical management of 48.67% (128/263) patients was positively affected by mNGS, and 51.33% (135/263) patients were not affected by mNGS(P = 0.1074). To sum up, infectious diseases are the principal cause of FUO. mNGS could significantly improve the detected pathogen spectrum of FUO caused by infection. However, the FUO disease spectrum is relatively broad, including a large number of non-infectious diseases. Therefore, Further investigation is warranted into the specific clinical scenarios for which mNGS may offer the greatest clinical diagnostic value.
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