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A recurrent lung abscess caused by delayed diagnosis of unique co-infection with Abiotrophia defectiva
Ilaria Onorati1, Patrice Guiraudet1, Typhaine Billard-Pomares2
1Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Paris 13, Sorbonne Paris Nord, Paris, France.
Abstract:
We report the case of a lung abscess due to Prevotella baroniae with a co-infection by Abiotrophia defective, which is a 'nutritionally variant streptococci' (NVS), in a 48-year-old patient. The delayed diagnosis of this co-infection led to multiple failures of medical treatment and need for surgery. Pathogenicity of these bacteria is well known, particularly in endocarditis, but not in lung infection. In pulmonary abscesses, co-infection with NVS is difficult to detect. It may explain some medical treatment failures. This case highlights the importance to systematically search for and consider NVS in such clinical contexts.
Insights
A rare lung abscess co-infection involving Prevotella baroniae and nutritionally variant streptococci (NVS) led to treatment failure. Early detection of NVS is crucial for effective management of pulmonary abscesses.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Lung abscesses are serious infections requiring prompt diagnosis and treatment.
- Prevotella baroniae is a known pathogen, but co-infections, especially with nutritionally variant streptococci (NVS), are less understood in pulmonary contexts.
Observation:
- A 48-year-old patient presented with a lung abscess.
- The abscess was caused by a co-infection of Prevotella baroniae and Abiotrophia defective, a type of NVS.
- Diagnosis of the NVS co-infection was delayed.
Findings:
- The co-infection with NVS contributed to multiple medical treatment failures.
- Surgical intervention became necessary due to the complexity of the infection.
- Abiotrophia defective (NVS) is challenging to detect in pulmonary abscesses.
Implications:
- This case underscores the importance of considering and systematically testing for NVS co-infections in lung abscesses.
- Failure to identify NVS may lead to prolonged illness and treatment resistance.
- Awareness of NVS in pulmonary infections can improve patient outcomes and guide therapeutic strategies.
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