Tani Tetsuo, Takehara Tomohiro, Ishioka Kota, Yoshifuji Ayumi, Aoki Kotaro, Takahashi Saeko
Department of Pulmonary Medicine Tokyo Saiseikai Central Hospital Tokyo Japan.
Department of infectious diseases Keio University School of Medicine Tokyo Japan.
Respirol Case Rep. 2024 May 14;12(5):e01384. doi: 10.1002/rcr2.1384. eCollection 2024 May.
A 70-year-old immunocompetent male with a history of insomnia presented with pneumonia and bacteremia caused by . The patient took benzodiazepines and regularly consumed alcohol and natto (fermented soybeans). Initial antibiotic treatment was not effective, and bronchoalveolar lavage was performed. Bronchoalveolar lavage fluid (BALF) analysis revealed an increased lymphocytes fraction, and was detected in the BALF. Whole-genome sequencing confirmed the congruence of the genetic sequences between the strain in the blood culture of the patient, BALF, and strain isolated from the consumed natto, confirming subsp as the causative pathogen of pneumonia and bacteremia. Vancomycin followed by levofloxacin and systemic corticosteroid were used to treat the condition. This case highlights community-acquired pneumonia and bacteremia caused by subsp, particularly in individuals who consume natto.
一名70岁免疫功能正常的男性，有失眠病史，因……出现肺炎和菌血症。患者服用苯二氮䓬类药物，经常饮酒和食用纳豆（发酵大豆）。初始抗生素治疗无效，遂进行支气管肺泡灌洗。支气管肺泡灌洗液（BALF）分析显示淋巴细胞比例增加，且在BALF中检测到……。全基因组测序证实患者血培养、BALF中的菌株与从食用的纳豆中分离出的菌株的基因序列一致，确认……亚种为肺炎和菌血症的致病病原体。先使用万古霉素，后使用左氧氟沙星和全身用糖皮质激素治疗该病症。本病例突出了由……亚种引起的社区获得性肺炎和菌血症，尤其是在食用纳豆的个体中。
