Shen Ya, Cao Xiao-Yu, Shi Jing-Feng, Cao Zi-Xiao, Teng Xiao-Bao, Han Ming-Feng
Department of Respiratory and Critical Care Medicine, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, Anhui, China.
Front Med (Lausanne). 2025 Jul 2;12:1607223. doi: 10.3389/fmed.2025.1607223. eCollection 2025.
The emergence of next-generation sequencing (NGS) has significantly improved the detection rate of Actinomyces species in pulmonary actinomycosis (PA), a rare and diagnostically challenging infectious disease. Here, we report a case of an elderly patient with a history of pyoderma gangrenosum who presented with pulmonary infiltrates and was subsequently hospitalized. Both histopathological examination of tracheoscopic biopsy specimens and NGS analysis of bronchoalveolar lavage fluid (BALF) confirmed infection with (). The patient exhibited marked clinical and radiological improvement following a period of amoxicillin/clavulanic acid therapy. Additionally, we performed a retrospective analysis of 11 documented cases of -associated pneumonia reported between 1978 and 2025. These cases were primarily diagnosed through pathogen culture and histopathology, with most patients demonstrating favorable outcomes following timely intervention. The age distribution of the cohort ranged from 11 to 64 years, with cough, sputum production, and dyspnea being the predominant symptoms. Notably, chest imaging findings varied widely. We anticipate that these findings will enhance clinical awareness of PA, facilitating early detection, accurate diagnosis, and improved patient management. To our knowledge, this represents the first reported case of pneumonia diagnosed using a combined NGS and histopathology approach, as well as the largest case series published for this condition.
下一代测序（NGS）技术的出现显著提高了肺放线菌病（PA）中放线菌属的检出率，PA是一种罕见且诊断具有挑战性的传染病。在此，我们报告一例患有坏疽性脓皮病史的老年患者，该患者出现肺部浸润并随后住院。气管镜活检标本的组织病理学检查和支气管肺泡灌洗液（BALF）的NGS分析均证实感染了（）。在接受一段时间的阿莫西林/克拉维酸治疗后，患者的临床和影像学表现有显著改善。此外，我们对1978年至2025年间报告的11例与（）相关的肺炎病例进行了回顾性分析。这些病例主要通过病原体培养和组织病理学诊断，大多数患者在及时干预后预后良好。该队列的年龄分布为11至64岁，主要症状为咳嗽、咳痰和呼吸困难。值得注意的是，胸部影像学表现差异很大。我们预计这些发现将提高临床对PA的认识，促进早期发现、准确诊断和改善患者管理。据我们所知，这是首例使用NGS和组织病理学联合方法诊断的（）肺炎病例，也是针对该病症发表的最大病例系列。
