Zhang Fangqi, Wang Juan-Li, Zhu Jian, Si Shaokui, Guo Hao, Yue Xiang, Wen Wei
Department of Pulmonary and Critical Care Medicine, The 987th Hospital of Joint Logistics Support Force of People's Liberation Army, Baoji, China.
Department of Child Healthcare, The Third Hospital of Wuhan, Wuhan, China.
Front Med (Lausanne). 2025 Jan 29;12:1517389. doi: 10.3389/fmed.2025.1517389. eCollection 2025.
Severe infections that develop rapidly from ordinary symptoms not only increase patient misunderstandings but also lead to excessive detection of these symptoms by physicians. This case study describes a 19-year-old male individual who initially presented with a sore throat and subsequently developed multiple serous cavity effusions that lead to septic pulmonary embolism and septic shock. After multiple cultures of the patient's sputum yielded no identifiable pathogenic bacteria, the metagenomic next-generation sequencing (mNGS) revealed as the predominant pathogen present in both the patient's peripheral blood and the pericardial drainage fluid. The subsequent antibiotic treatment, guided by the mNGS results, along with surgical drainage and mediastinal irrigation, effectively controlled and ultimately cured the patient's condition. This case is unique because it is the first to show that normally colonizing can also cause fatal multiorgan infection as an opportunistic pathogen in a previously healthy young person with no immune-related diseases. The aim of this study is to expand clinical awareness of this common symptom and its potentially fatal outcome.
从普通症状迅速发展而来的严重感染不仅会增加患者的误解，还会导致医生对这些症状进行过度检测。本病例研究描述了一名19岁男性，最初表现为喉咙痛，随后出现多处浆膜腔积液，导致脓毒性肺栓塞和感染性休克。在对患者痰液进行多次培养均未发现可识别的致病菌后，宏基因组下一代测序（mNGS）显示 是患者外周血和心包引流液中存在的主要病原体。随后在mNGS结果的指导下进行抗生素治疗，同时进行手术引流和纵隔冲洗，有效控制并最终治愈了患者的病情。该病例独特之处在于，这是首次表明正常定植的 在一名先前健康、无免疫相关疾病的年轻人中也可作为机会性病原体引起致命的多器官感染。本研究的目的是提高对这种常见症状及其潜在致命后果的临床认识。 （注：原文中“ revealed as the predominant pathogen”处有缺失信息未完整给出）
