Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Feb 16:14:1236630.
doi: 10.3389/fcimb.2024.1236630. eCollection 2024.

Case report: Metagenomics next-generation sequencing in the diagnosis of septic shock due to Fusobacterium necrophorum in a 6-year-old child

Haiyang Zhang  1   2 , Zhongqiang Liu  1   2 , Yuanlin Guan  3 , Deyuan Li  1   2 , Hanmin Liu  2   4 , Lingying Ruan  2   4
Affiliations
Case Reports

Case report: Metagenomics next-generation sequencing in the diagnosis of septic shock due to Fusobacterium necrophorum in a 6-year-old child

Haiyang Zhang et al. Front Cell Infect Microbiol. .

Abstract

Fusobacterium necrophorum (F. necrophorum) infection is rare in pediatrics. In addition, the detection time of F. necrophorum by blood culture is long, and the positive rate is low. Infection with F. necrophorum bacilli usually follows rapid disease progression, resulting in high mortality. In previous reports of F. necrophorum-related cases, the most dangerous moment of the disease occurred after the appearance of Lemierre's syndrome. We report an atypical case of a 6-year-old female patient who developed septic shock within 24 h of admission due to F. necrophorum infection in the absence of Lemierre's syndrome. F. necrophorum was identified in a blood sample by metagenomics next-generation sequencing (mNGS) but not by standard blood culture. The patient was finally cured and discharged after receiving timely and effective targeted anti-infection treatment. In the present case study, it was observed that the heightened virulence and invasiveness of F. necrophorum contribute significantly to its role as a primary pathogen in pediatric septic shock. This can precipitate hemodynamic instability and multiple organ failure, even in the absence of Lemierre's syndrome. The use of mNGS can deeply and rapidly identify infectious pathogens, guide the use of targeted antibiotics, and greatly improve the survival rate of patients.

Keywords: Fusobacterium necrophorum; case report; children; metagenomics next-generation sequencing; sepsis.

PubMed Disclaimer

Conflict of interest statement

Author YG is employed by Hugobiotech Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The patient’s oropharynx showed a markedly swollen bilateral tonsil with white, purulent exudates.
Figure 2
Figure 2
Chest CT in the clinical course of the patient: (A) Multiple small patchy hyperdense shadows and nodular shadows in both lungs (the day of admission). (B) The laryngeal–pharyngeal area was slightly narrow (red arrow, the day of admission). (C) Patchy hyperdense shadows were absorbed, and nodule shadows were significantly reduced (the 14th day of admission). (D) No evidence of internal jugular vein thrombophlebitis or abscess, the morphology of the laryngeal pharyngeal area returned to normal (red arrow, the 14th day of admission).
Figure 3
Figure 3
The coverage and abundance of F. necrophorum detected by mNGS using blood on the third day of admission. In the Others section, the total number of sequences was 2,642 reads and the percent was 99.21%, including Prevotella, Acinetobacter, Stenotrophomonas, and Neisseria (the human reads were removed).
Figure 4
Figure 4
(A) The timeline of disease progression and treatment. (B) The flowchart of the mNGS process.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Almohaya A. M., Almutairy T. S., Alqahtani A., Binkhamis K., Almajid F. M. (2020). Fusobacterium bloodstream infections: A literature review and hospital-based case series. Anaerobe 62, 102165. doi: 10.1016/j.anaerobe.2020.102165 - DOI - PubMed
    1. Bharucha T., Oeser C., Balloux F., Brown J. R., Carbo E. C., Charlett A., et al. . (2020). STROBE-metagenomics: a STROBE extension statement to guide the reporting of metagenomics studies. Lancet Infect. Dis. 20, e251–e260. doi: 10.1016/S1473-3099(20)30199-7 - DOI - PMC - PubMed
    1. Blauwkamp T. A., Thair S., Rosen M. J., Blair L., Lindner M. S., Vilfan I. D., et al. . (2019). Analytical and clinical validation of a microbial cell-free DNA sequencing test for infectious disease. Nat. Microbiol. 4, 663–674. doi: 10.1038/s41564-018-0349-6 - DOI - PubMed
    1. Brennan C. A., Garrett W. S. (2019). Fusobacterium nucleatum-symbiont, opportunist and oncobacterium. Nat. Rev. Microbiol. 17, 156–166. doi: 10.1038/s41579-018-0129-6 - DOI - PMC - PubMed
    1. Carius B. M., Koyfman A., Long B. (2022). High risk and low prevalence diseases: Lemierre’s syndrome. Am. J. Emerg. Med. 61, 98–104. doi: 10.1016/j.ajem.2022.08.050 - DOI - PubMed

Publication types

Substances

LinkOut - more resources