Zhang Haiyang, Liu Zhongqiang, Guan Yuanlin, Li Deyuan, Liu Hanmin, Ruan Lingying
Department of Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Front Cell Infect Microbiol. 2024 Feb 16;14:1236630. doi: 10.3389/fcimb.2024.1236630. eCollection 2024.
() infection is rare in pediatrics. In addition, the detection time of by blood culture is long, and the positive rate is low. Infection with bacilli usually follows rapid disease progression, resulting in high mortality. In previous reports of -related cases, the most dangerous moment of the disease occurred after the appearance of Lemierre's syndrome. We report an atypical case of a 6-year-old female patient who developed septic shock within 24 h of admission due to infection in the absence of Lemierre's syndrome. was identified in a blood sample by metagenomics next-generation sequencing (mNGS) but not by standard blood culture. The patient was finally cured and discharged after receiving timely and effective targeted anti-infection treatment. In the present case study, it was observed that the heightened virulence and invasiveness of contribute significantly to its role as a primary pathogen in pediatric septic shock. This can precipitate hemodynamic instability and multiple organ failure, even in the absence of Lemierre's syndrome. The use of mNGS can deeply and rapidly identify infectious pathogens, guide the use of targeted antibiotics, and greatly improve the survival rate of patients.
（）感染在儿科中较为罕见。此外，通过血培养检测（该病原体）的时间较长，且阳性率较低。感染（该）杆菌通常会导致疾病快速进展，死亡率较高。在先前关于（该病原体）相关病例的报道中，疾病最危险的时刻发生在勒米尔综合征出现之后。我们报告一例非典型病例，一名6岁女性患者在入院后24小时内由于（该病原体）感染而发生感染性休克，且未出现勒米尔综合征。通过宏基因组学下一代测序（mNGS）在血样中鉴定出了（该病原体），但标准血培养未检测到。患者在接受及时有效的靶向抗感染治疗后最终治愈出院。在本病例研究中，观察到（该病原体）增强的毒力和侵袭性显著促成了其作为儿科感染性休克主要病原体的作用。这可导致血流动力学不稳定和多器官功能衰竭，即使在没有勒米尔综合征的情况下也是如此。使用mNGS可以深入快速地鉴定感染病原体，指导靶向抗生素的使用，并大大提高患者的生存率。
