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Case Reports
. 2014 May;6(5):553-7.
doi: 10.3978/j.issn.2072-1439.2014.02.16.

Necrotizing pneumonia and empyema caused by Neisseria flavescens infection

Ling Huang  1 , Lan Ma  1 , Kun Fan  1 , Yang Li  1 , Le Xie  1 , Wenying Xia  1 , Bing Gu  1 , Genyan Liu  1
Affiliations
Case Reports

Necrotizing pneumonia and empyema caused by Neisseria flavescens infection

Ling Huang et al. J Thorac Dis. 2014 May.

Abstract

Neisseria flavescens is an uncommon pathogen of human infection, pneumonia and empyema caused by N. flavescens is rarely reported. Herein, we report a 56-year-old diabetic patient presenting necrotising pneumonia and empyema due to N. flavescens infection. The main clinical manifestation of this patient was high fever, sticky pus and gradually aggravating dyspnea. The chest computed tomography (CT) scan showed there are mass of high density areas around hilus of the left lung, hollow sign with inflammation also appeared. A biopsy specimen was taken from the left principal bronchus by lung puncture biopsy and showed necrosis and inflammation. Microscopic examination of direct smear and culture of sticky pus, much more gram-negative diplococcus was present, pathogen was further identified by Vitek NH card, Vitek MS and confirmed as N. flavescens by 16S rRNA gene sequencing finally. Anti-infection therapy following the antimicrobial susceptibility test results was effectively. To our knowledge, this is the first report of pulmonary infection caused by N. flavescens.

Keywords: 16S rRNA gene sequencing; MALDI-TOF MS; Neisseria flavescens; empyema; pneumonia.

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Figures

Figure 1
Figure 1
CT scan of the chest. (A) High-density shadow around the hilus of left lung (black arrow); (B) It appears that there is a hollow sign (black arrow) in the peripheral pulmonary. CT, computed tomography.
Figure 2
Figure 2
Direct smear Gram stain before and after anti-infection. (A) Direct smear Gram stain of pyogenic fluids before treatment. There are lots of gram-negative diplococcus as well as pyocyte infiltration; (B) Direct smear Gram stain of pyogenic fluids after effective treatment, the diplococcus disappeared. (Gram stain,1,000×).
Figure 3
Figure 3
Biospy of principal bronchus mucous membrane. (A) Biospy of distal end of left principal bronchus mucous membrane with deeply acidophilic and fibrinoid necrosis; (B) Biospy of distal end of left principal bronchus cartilage with deeply acidophilic, fibrinoid necrosis and exudation. (H&E stain, 200×).
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