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CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 |
doi: 10.3389/fmed.2024.1382134
Unveiling the Dark Side of Prevotella: A Case of Fatal Pneumonia from a Common Probiotic
Provisionally accepted- 1 Wuhan Jinyintan Hospital, Wuhan, China
- 2 General Hospital of Central Theater Command, Wuhan, Hubei Province, China
Prevotella is often considered a Bacteroides complex associated with a healthy plant-based diet that acts as a "probiotic" throughout the body's entire digestive tract from the mouth to the anus. Previous studies have not reported that this "probiotic" colonizing the human body could cause severe pneumonia. This case report describes a 56year-old healthy female worker with gum pain followed by fever.Despite prompt medical attention given by the use of empirical antibiotics and tooth and oral cleaning, the disease rapidly progressed to retropharyngeal abscess and severe pneumonia. Although the surgeon performed pharynx and cervical incisions and drainage, the patient's symptoms were not significantly relieved. After repeated blood culture and sputum culture, no positive findings were found.Fortunately, Prevotella oris was found in the peripheral blood of the patient by metagenomic next-generation sequencing (mNGS). The disease was controlled quickly by changing the targeted antibiotics according to the guidelines for the detection of pathogenic bacteria.Three months after discharge, the patient's symptoms did not resolve, and reexamination with computerized tomography (CT) showed that the neck and chest were normal. This case is unique in that it shows that normally colonized Prevotella oris could also cause fatal pneumonia as an opportunistic pathogen. Our goal is to highlight that serious infections that rapidly develop from common symptoms in an era of widespread antibiotic use not only increase patient misunderstanding but also lead to over detection and testing of such symptoms by clinicians. Expanding the pathogenic characteristics of special pathogens through the literature and using accurate mNGS may be the technical tool for resolving this contradiction.
Keywords: Prevotella, Gum pain, Septic emboli, Necrotizing mediastinitis, Lemierre's syndrome
Received: 11 Feb 2024; Accepted: 12 Nov 2024.
Copyright: © 2024 Li, Zhou, Zhang, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lei Li, Wuhan Jinyintan Hospital, Wuhan, China
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