Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
J Med Case Rep. 2024 Apr 30;18(1):213. doi: 10.1186/s13256-024-04538-8.
Prevotella heparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans.
A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed tomography scan was conducted, which revealed multiple patchy nodular opacities in both lungs. On admission, the patient presented with a temperature of 38.1 °C and a pulse rate of 110 beats per minute. Despite routine anti-infective treatment with moxifloxacin, his temperature fluctuated and the treatment was ineffective. The patient was diagnosed with Prevotella heparinolytica infection through metagenomic next-generation sequencing. Therefore, the antibiotics were switched to piperacillin-tazobactam in combination with ornidazole, which alleviated his symptoms; 1 week after discharge, the patient returned to the clinic for a follow-up chest computed tomography, and the opacities on the lungs continued to be absorbed.
Prevotella heparinolytica is an opportunistic pathogen. However, it has not been reported in human pneumonia. In refractory pneumonia, measures such as metagenomic next-generation sequencing can be used to identify pathogens and help guide antibiotic selection and early support.
普雷沃氏菌肝素解旋酶是一种革兰氏阴性菌，通常存在于口腔、肠道和泌尿道中。它在马的下呼吸道感染中被广泛研究，具有肝素解旋活性，并能分泌肝素酶，进一步诱导细胞中的毒力因子，导致疾病。然而，在人类中尚未有此类病例报道。
一名 58 岁的中国男性患者因咳嗽有痰 20 天伴发热 3 天就诊于苏州呼吸科门诊。在此之前，患者进行了胸部计算机断层扫描，显示双肺多发性斑片状结节状阴影。入院时，患者体温为 38.1°C，脉搏为 110 次/分。尽管常规使用莫西沙星进行抗感染治疗，但他的体温仍有波动，治疗无效。通过宏基因组下一代测序，该患者被诊断为普雷沃氏菌肝素解旋酶感染。因此，抗生素更换为哌拉西林他唑巴坦联合奥硝唑，症状得到缓解；出院后 1 周，患者返回门诊进行胸部 CT 随访，肺部的阴影继续吸收。
普雷沃氏菌肝素解旋酶是一种机会致病菌。然而，它在人类肺炎中尚未有报道。在难治性肺炎中，可以采用宏基因组下一代测序等措施来识别病原体，帮助指导抗生素的选择和早期支持。
