Zang Dan-Yang, Li Lu-Guang, Yang Shu-Guang, Wang Yuan-Yuan, Yu Xue-Qing
Department of Respiratory, The First Affiliated Hospital of Henan University of CM, Zhengzhou 450000, Henan Province, China.
Department of Bronchoscopy, The First Affiliated Hospital of Henan University of CM, Zhengzhou 450000, Henan Province, China.
World J Clin Cases. 2025 Aug 26;13(24):105923. doi: 10.12998/wjcc.v13.i24.105923.
is commonly found in fermented foods and very few infected patients have been reported, who typically present symptoms such as fever and fatigue. Conventional clinical examinations often struggle to identify this bacterium, and routine anti-infective treatments are generally ineffective. Both diagnostic challenges and therapeutic limitations pose significant difficulties for clinicians.
We report a patient ultimately diagnosed with infection. The primary manifestations included persistent fever, cough and fatigue. These symptoms lasted for 2 months. He received anti-infective treatment at a community hospital, but this was ineffective. After inquiring about the patient's medical history and conducting a physical examination, the patient underwent laboratory tests. Complete blood count tests revealed that the patient had a high proportion of neutrophils, C-reactive protein level was 235.9 mg/L, erythrocyte sedimentation rate was 67 mm/h, respiratory pathogen testing was negative, and he was then thought to have an infectious disease. However, conventional anti-infective treatments were ineffective. After excluding infectious neurological diseases, urologic diseases and digestive problems, we ultimately focused our attention on the lungs. A lung computed tomography scan indicated pulmonary inflammation. Bronchoalveolar lavage fluid for next-generation sequencing suggested lung infection with The patient's symptoms gradually improved following treatment with piperacillin tazobactam and linezolid. During the follow-up period, the patient's temperature remained normal.
For patients with suspected bacterial infection and experiencing fever, conventional anti-infective treatment can be ineffective in controlling their symptoms, and an infection due to rare bacteria or drug-resistant bacteria should be considered. Next-generation sequencing enables rapid and precise identification of infection-related pathogens in febrile patients.
常见于发酵食品中，报道的感染患者极少，典型症状为发热和疲劳。传统临床检查往往难以识别这种细菌，常规抗感染治疗通常无效。诊断挑战和治疗局限性给临床医生带来了重大困难。
我们报告了一名最终被诊断为感染的患者。主要表现为持续发热、咳嗽和疲劳。这些症状持续了2个月。他在社区医院接受了抗感染治疗，但无效。询问患者病史并进行体格检查后，患者接受了实验室检查。血常规检查显示患者中性粒细胞比例高，C反应蛋白水平为235.9mg/L，红细胞沉降率为67mm/h，呼吸道病原体检测为阴性，当时认为患有传染病。然而，常规抗感染治疗无效。排除感染性神经疾病、泌尿系统疾病和消化系统问题后，我们最终将注意力集中在肺部。肺部计算机断层扫描显示肺部炎症。支气管肺泡灌洗 fluid 用于下一代测序提示肺部感染 患者接受哌拉西林他唑巴坦和利奈唑胺治疗后症状逐渐改善。在随访期间，患者体温保持正常。
对于疑似细菌感染且发热的患者，常规抗感染治疗可能无法有效控制其症状，应考虑罕见细菌或耐药细菌引起的感染。下一代测序能够快速、准确地识别发热患者中与感染相关的病原体。
