• Cuiying Zheng, Jiaqing Ye, Minghui Song, Yumei Guo, Weili Gao, Jiahao Hao, Zhongjun Feng, and Lijie Zhang.
• Department of Clinical Laboratory, The Third Hospital of Hebei Medical University, Hebei, China.
• Medicine (Baltimore). 2024 Jan 19; 103 (3): e36921e36921.

RationaleAnthrax is a severe zoonotic infectious disease caused by Bacillus anthracis. Most reported cases were traditionally diagnosed through culture and microscopy. We reported here the second case of cutaneous anthrax diagnosed by metagenomic next-generation sequencing (mNGS).Patient ConcernsA 63-year-old man had a history of contact with an unwell sheep, developing local redness and swelling on wrist. The dorsal side of the left hand and forearm, with tension blisters on the back of the left.DiagnosisB anthracis was detected from culturing and mNGS of tension blisters.InterventionsOn the second day of admission, the patient was administered 3.2 million units of penicillin every 6 hours, and isolated and closely observed.OutcomesThe patient improves and is discharged.LessonsTraditional bacterial cultures are time-consuming, while mNGS offers the advantage of accurate, quick, high-throughput, unbiased sequencing of all genetic material in a sample, which is a good technical tool for assisting in the diagnosis of rare pathogen infections.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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