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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Apr 7, 2026; 32(13): 114563
Published online Apr 7, 2026. doi: 10.3748/wjg.v32.i13.114563
Isolated colonic aspergillosis in an immunocompetent individual diagnosed by metagenomic next-generation sequencing: A case report
Ting Guo, Xian Wang, Shao-Yang Wang, Tao-Fa Lin
Ting Guo, Department of Infections, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, Fujian Province, China
Xian Wang, Shao-Yang Wang, Tao-Fa Lin, Department of Infections, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou 350025, Fujian Province, China
Author contributions: Guo T designed the report; Lin TF and Wang X collected the patient’s clinical data; Guo T, Wang X, and Wang SY analyzed the data and wrote the manuscript; Lin TF reviewed the work and is the corresponding author of this manuscript; and all authors reviewed and approved the final manuscript.
Supported by the Subproject of National Key Research and Development Program of China, No. 2022YFC2305000.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Corresponding author: Tao-Fa Lin, MM, Academic Fellow, Attending Physician, Department of Infections, 900th Hospital of PLA Joint Logistic Support Force, No. 156 West Second Ring North Road, Gulou District, Fuzhou 350025, Fujian Province, China. ltfa2016@qq.com
Received: September 24, 2025
Revised: November 14, 2025
Accepted: February 2, 2026
Published online: April 7, 2026
Processing time: 184 Days and 18.8 Hours
Core Tip

Core Tip: This case report describes an unusual presentation of refractory diarrhea in a patient who was immunocompetent and had none of the usual risk factors. Despite comprehensive evaluations including endoscopy and histopathology, the etiology remained undetermined. Metagenomic next-generation sequencing (mNGS) identified Aspergillus fumigatus, guiding successful targeted treatment. This highlights the necessity of considering primary intestinal aspergillosis (PA) in certain patients and demonstrates the diagnostic value of mNGS for rare fungal enteritis. Although publication bias may exist, accumulating case reports support considering PA when diagnosing unexplained diarrhea. Furthermore, the use of mNGS is justified when conventional diagnostic methods are inconclusive.