A case of necrotic pneumonia caused by Streptococcus pneumoniae was diagnosed using a pneumonia antigen test in BALF: A case report.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins

Streptococcus pneumoniae*/isolation & purification ; Streptococcus pneumoniae*/immunology ; Bronchoalveolar Lavage Fluid*/microbiology ; Pneumonia, Pneumococcal*/diagnosis ; Pneumonia, Pneumococcal*/microbiology ; Antigens, Bacterial*/analysis ; Antigens, Bacterial*/immunology; Humans ; Male ; Aged ; Pneumonia, Necrotizing/diagnosis ; Pneumonia, Necrotizing/microbiology ; Anti-Bacterial Agents/therapeutic use ; Tomography, X-Ray Computed

Rationale: Streptococcus pneumoniae is a common cause of community-acquired pneumonia. Currently, it is believed that many cases of pulmonary infection with negative results on pathogenic testing are caused by S. pneumoniae. There have been no reports of the detection of S. pneumoniae antigen in lung lavage fluid.
Patient Concerns: An elderly male patient with suboptimal fasting blood glucose control and a history of liver abscess.
Diagnosis: Chest computed tomography (CT) revealed inflammatory lesions in both lungs with consolidation in the middle lobe of the right lung.
Interventions: After admission, we collected alveolar lavage fluid in a timely manner and performed pneumococcal antigen detection and etiological testing.
Outcomes: Prompt testing for pneumococcal antigen in bronchoalveolar lavage fluid yielded a positive clinical outcome. Subsequent analysis via bacterial culture of sputum and next-generation sequencing (mNGS) of BALF definitively identified S. pneumoniae as the etiological agent. Following the analysis of drug sensitivity test results from the identified pathogens, adjustments were made to the antibiotic regimen, and appropriate pus puncture drainage was performed. Subsequently, the patient's condition improved, leading to discharge.
Conclusion: The identification of S. pneumoniae antigen in bronchoalveolar lavage fluid may facilitate earlier and more precise diagnosis of pneumonia attributed to S. pneumoniae.
Competing Interests: The authors have no funding and conflicts of interest to disclose.
(Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

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0 (Antigens, Bacterial)
0 (Anti-Bacterial Agents)

Date Created: 20240910 Date Completed: 20240910 Latest Revision: 20241023

20241023

PMC11383723

10.1097/MD.0000000000039571

39252254