Advantages of NGS: Diagnostics and Clinical Indications Case Reports with Dr. Wayne Rosenkrantz
A culture result may identify an organism without fully accounting for the patient’s clinical presentation, cytology, or response to treatment.
In this case-based presentation, Dr. Wayne Rosenkrantz, DVM, DACVD, examines two canine infections in which MiDOG’s next-generation sequencing technology identified uncommon pathogens that previous culture results did not adequately explain.
The cases of Lily and Cooper reached very different outcomes, reinforcing an important clinical lesson: accurate pathogen identification matters, but when that organism is identified can also shape the path forward.
Lily: An Uncommon Fungal Infection
Lily, a two-year-old German Shepherd, presented with severe weight loss, lymphadenopathy, limb swelling, and draining skin lesions.
Previous culture reported methicillin-resistant Staphylococcus pseudintermedius. However, Lily’s clinical findings and cytology raised concern for a more unusual fungal infection.
MiDOG testing identified Acremonium borodinense, a rarely reported opportunistic fungus. Unfortunately, the systemic infection was already advanced when the organism was identified, and Lily continued to deteriorate despite antifungal therapy.
Her case illustrates the challenges clinicians may face when an initial result does not adequately explain the severity or progression of disease.
Cooper: Earlier Identification, a Different Outcome
Cooper developed a non-healing paw wound while receiving immunosuppressive treatment for immune-mediated hemolytic anemia.
Local culture reported a Pseudomonas-like organism. MiDOG testing instead identified Burkholderia gladioli as 99.8% of the bacterial profile, a finding that was subsequently confirmed by PCR.
With the organism identified, Dr. Rosenkrantz was able to reduce Cooper’s immunosuppressive therapy and administer a six-week course of marbofloxacin. Cooper’s lesions resolved, and he experienced a positive long-term outcome.
The case became the first published report of B. gladioli infection in a dog.
What This Presentation Covers
Watch the video to learn how next-generation sequencing can support veterinary investigation of:
- Rare or unexpected pathogens
- Fungal infections
- Anaerobic and slow-growing bacteria
- Culture-negative or inconclusive findings
- Mixed microbial communities
- Antimicrobial resistance markers
- Biofilm-associated infections
- Cases in which the reported organism does not match the clinical presentation
About Dr. Wayne Rosenkrantz
Dr. Wayne Rosenkrantz is a board-certified veterinary dermatologist and MiDOG Board Member. In this presentation, he draws from two clinical cases to demonstrate how NGS findings can be evaluated alongside patient history, cytology, lesion progression, previous testing, and treatment response.
Watch the Presentation
See how MiDOG testing helped clarify the infectious disease findings in two challenging canine dermatology cases, and why the timing of pathogen identification contributed to two very different outcomes.
Explore MiDOG All-in-One Testing
The MiDOG All-in-One Test analyzes microbial DNA directly from a clinically relevant sample to identify bacteria, fungi, and antimicrobial resistance markers without requiring organisms to grow in culture.
Results are designed to support veterinary decision-making and should always be interpreted alongside the patient’s clinical signs, history, sample type, and other diagnostic findings.
Explore MiDOG All-in-One Testing
https://www.midogtest.com/all-in-one-test/
