Background
Case presentation
< Blood cell count > | |
White blood cell | 7,150 /μL |
Red blood cell | 520 × 104 /μL |
Hemoglobin | 14.8 g/dL |
Platelet | 27.8 × 104 /μL |
< Serum chemistry> | |
Total protein | 8.1 g/dL |
Albumin | 4.6 g/dL |
Total-bilirubin | 0.5 mg/dL |
Alkaline phosphatase | 252 IU/L |
Aspartate transaminase | 15 IU/L |
Alanine transaminase | 23 IU/L |
γ-Glutamyl transpeptidase | 30 IU/L |
Lactate dehydrogenase | 158 IU/L |
Blood urea nitrogen | 11 mg/dL |
Creatinine | 0.84 mg/dL |
C-reactive protein | 1.02 mg/dL |
Sodium | 141 mmol/L |
Potassium | 4.4 mmol/L |
Chlorine | 103 mmol/L |
< Coagulation> | |
Prothrombin time (International normalized ratio) | 1.09 |
Activated partial thromboplastin time | 50 s |
< Infection > | |
Rapid plasma reagin test | Positive (titers 1:64) |
Treponema pallidum hemagglutination test | Positive (titers 1:5,120) |
Hepatitis B surface antigen | Negative |
Hepatitis C antibody | Negative |
Human immunodeficiency virus antibody | Negative |
Aspergillus antigen | Negative |
Cryptococcus antigen | Negative |
< Tumor marker > | |
Carcinoembryonic antigen | < 1 ng/mL |
Soluble cytokeratin fragment | 0.5 ng/mL |
Pro-gastrin releasing peptide | 27.0 pg/mL |
<Autoantibody> | |
Proteinase3-antineutrophil cytoplasmic antibody | < 1 U/mL |
Myeroperoxidase-antineutrophil cytoplasmic antibody | < 1 U/mL |
1. Bronchofiberscopy | ||
PCR tests for Treponema pallidum | ||
Bronchoalveolar lavage | Undetected | |
TBB | Detected (tpp47-PCR and polA-PCR) | |
Culture tests for bacteria and mycobacteria | ||
Bronchoalveolar lavage | Undetected | |
Lavage of forceps in TBB | Undetected | |
2. Surgery | ||
Real-time PCR tests for Treponema pallidum | Undetected | |
Culture test for bacteria in pus inside the abscess | Undetected | |
Real-time PCR tests for multi-microbes [17] | ||
Number | Bacteria name | Quantity |
1 |
Staphylococcus aureus
| Undetected |
2 |
Bacillus anthracis
| Undetected |
3 |
Listeria monocytogenes
| Undetected |
4 |
Streptococcus pyogenes
| Undetected |
5 |
Streptococcus agalactiae
| Undetected |
6 |
Streptococcus mutans
| Undetected |
7 |
Streptococcus sobrinus
| Undetected |
8 |
Streptococcus sanguinis
| Undetected |
9 |
Streptococcus oralis
| Undetected |
10 |
Streptococcus salivaris
| Undetected |
11 |
Streptococcus pneumoniae
| Undetected |
12 |
Enterococcus faecalis
| Undetected |
13 |
Enterococcus faecium
| Undetected |
14 |
Clostridium tetani
| Undetected |
15 |
Clostridium difficile
| Undetected |
16 |
Peptostreptococcus anaerobius
| Undetected |
17 |
Actinomyces
| Undetected |
18 |
Corynebacterium diphtheriae
| Undetected |
19 |
Mycobacterium tuberculosis
| Undetected |
20 |
Mycobacterium laprae
| Undetected |
21 |
Mycobacterium chelonae
| Undetected |
22 |
Mycobacterium kansasii
| Undetected |
23 |
Mycobacterium avium complex
| Undetected |
24 |
Nocardia asteroids
| Undetected |
25 |
Bacteroides fragills
| Undetected |
26 |
Elizabethkingia meningosepticum
| Undetected |
27 |
Campylobacter jejuni
| Undetected |
28 |
Helicobacter cinaedi
| Undetected |
29 |
Helicobacter pylori
| Undetected |
30 |
Rickettsia prowazekii
| Undetected |
31 |
Rickettsia japonica
| Undetected |
32 |
Orientia tsutsugamushi
| Undetected |
33 |
Bartonella henselae
| Undetected |
34 |
Brucella
| Undetected |
35 |
Bordetella pertussis
| Undetected |
36 |
Burkhoderia mallei
| Undetected |
37 |
Burkhoderia cepacian
| Undetected |
38 |
Neisseria gonorrhoeae
| Undetected |
39 |
Neisseria meningitidis
| Undetected |
40 |
Francisella tularensis
| Undetected |
41 |
Legionella pneumophilia
| Undetected |
42 |
Moraxella catarrhalis
| Undetected |
43 |
Pseudomonas aeruginosa
| Undetected |
44 |
Acinetobacter baumannii
| Undetected |
45 |
Aeromonas hydrophia
| Undetected |
46 |
Vibrio cholerae
| Undetected |
47 |
Vibrio parahaemolyticus
| Undetected |
48 |
Vibrio vulnificus
| Undetected |
49 |
Haemophilus influenzae
| Undetected |
50 |
Escherichia coli
| Undetected |
51 |
Salmonella enterica
| Undetected |
52 |
Shigella
| Undetected |
53 |
Klebsiella pneumonia
| Undetected |
54 |
Yersinia psttis
| Undetected |
55 |
Yersinia enterocolitica
| Undetected |
56 |
Citrobacter freundii
| Undetected |
57 |
Proteus mirabilis
| Undetected |
58 |
Morganella morganii
| Undetected |
59 |
Providencia
| Undetected |
60 |
Mycoplasma pneumoniae
| Undetected |
61 |
Fusobacterium nucleatum
| Undetected |
62 |
Leptospira interrogans
| Undetected |
63 |
Chlamydia psittaci
| Undetected |
64 |
Chlamydia trachomatis
| Undetected |
65 |
Chlamydia pneumoniae
| Undetected |
66 |
Aspergillus fumigatus
| Undetected |
67 |
Aspergillus nigar
| Undetected |
68 |
Aspergillus flavus
| Undetected |
69 |
Cryptococcus
| Undetected |
70 |
Histoplasma
| Undetected |
71 |
Trichosporon
| Undetected |
72 |
Mucor
| Undetected |
73 |
Coccidioides
| Undetected |
74 |
Propionibacterium acnes
| Detected (not significant) |
75 |
Stenotrophomonas maltophilia
| Detected (not significant) |
76 |
Candida albicans
| Detected (not significant) |
Discussion and conclusions
Case no. | Age | Gender | Respiratory symptoms | Extrapulmonary symptoms | Chest imaging | Sample collection method | Reporting year | Reference |
---|---|---|---|---|---|---|---|---|
1 | 34 | Male | Chest pain | Progressive weakening, anorexia, weight loss, and night sweats | Several bilateral, round, excavated opacities and subtracheal adenopathy | BAL | 2006 | [13] |
2 | 49 | Female | Dry cough | Disabling cervical pain, fever, and night sweats | Lung lobe parenchymal lesion | BAL and bronchial aspirate | 2015 | [14] |
3 | 30 | Male | Hemoptysis, chest pain, dyspnea | Fever and rash | a 3 cm, irregularly-shaped, well-defined consolidation and a 1 cm hilar node | CTNA | 2018 | [15] |
4 | 62 | Male | No respiratory symptoms | epigastric pain | Multiple nodular bibasilar subpleural nodules | TBB | 2018 | [16] |