Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case

BackgroundThe genus Gardnerella is commonly found in the vaginal ecosystem and is considered a covert pathogen of the urinary tract. However, Gardnerella vaginalis had been the only recognized species of the genus Gardnerella for decades. Cases regarding the clinical relevance of Gardnerella leopold...

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Main Authors: Liangyou Chen, Wei Weng, Dan Li, Weipeng Xie, Lingling Lu, Shuo Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1548067/full
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author Liangyou Chen
Liangyou Chen
Wei Weng
Dan Li
Weipeng Xie
Lingling Lu
Shuo Li
Shuo Li
author_facet Liangyou Chen
Liangyou Chen
Wei Weng
Dan Li
Weipeng Xie
Lingling Lu
Shuo Li
Shuo Li
author_sort Liangyou Chen
collection DOAJ
description BackgroundThe genus Gardnerella is commonly found in the vaginal ecosystem and is considered a covert pathogen of the urinary tract. However, Gardnerella vaginalis had been the only recognized species of the genus Gardnerella for decades. Cases regarding the clinical relevance of Gardnerella leopoldii have rarely been reported, which is crucial for fully understanding the various species within the genus Gardnerella.Case presentationA 72-year-old female patient was admitted to the hospital with gross hematuria and complaints of waist soreness. Physical examinations, including those of the head, chest, and abdomen, along with routine laboratory tests such as white blood cell (WBC) count and proportion, liver function, and renal function, yielded normal results. However, the patient also exhibited significantly elevated levels of serum C-reactive protein (CRP) and abnormal urinary test findings, which revealed positive results for occult blood and leukocyte esterase, and increased counts of erythrocyte and leukocyte. To further evaluate the urinary system, computerized tomography urography (CTU) was performed. The CTU results revealed multiple weakly enhanced foci in the right kidney and thickening of the right ureter, renal pelvis, calyces, and bladder walls. Based on the above findings, the initial diagnosis included hematuria, hydronephrosis, and urinary tract infection (UTI). To identify the causative pathogens, we employed a comprehensive approach that included microscopic morphology, Sanger sequencing, and metagenomic next-generation sequencing (mNGS). Finally, both Mycobacterium tuberculosis and G. leopoldii were identified as the co-infecting etiological agents responsible for the patient’s urinary tract infection.ConclusionThis case represents the first documented isolation of clinically relevant G. leopoldii, guided by morphological and molecular evidence from a clinical urine sample. It highlights the potential of mNGS as a promising tool for identifying previously unrecognized species and offers valuable insights to enhance the understanding of clinically relevant microorganisms.
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spelling doaj-art-7b3b3dfb14a348dc9128b3611e4bca2b2025-08-20T03:09:52ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15480671548067Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection caseLiangyou Chen0Liangyou Chen1Wei Weng2Dan Li3Weipeng Xie4Lingling Lu5Shuo Li6Shuo Li7Department of Urology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, ChinaPrecision Medicine Center, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, ChinaDepartment of Clinical Laboratory, The Second Hospital of Jinhua, Jinhua, ChinaZhejiang Key Laboratory of Digital Technology in Medical Diagnostics, Dian Diagnostics Group Co., Ltd., Hangzhou, ChinaZhejiang Key Laboratory of Digital Technology in Medical Diagnostics, Dian Diagnostics Group Co., Ltd., Hangzhou, ChinaZhejiang Key Laboratory of Digital Technology in Medical Diagnostics, Dian Diagnostics Group Co., Ltd., Hangzhou, ChinaPrecision Medicine Center, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, ChinaZhejiang Key Laboratory of Digital Technology in Medical Diagnostics, Dian Diagnostics Group Co., Ltd., Hangzhou, ChinaBackgroundThe genus Gardnerella is commonly found in the vaginal ecosystem and is considered a covert pathogen of the urinary tract. However, Gardnerella vaginalis had been the only recognized species of the genus Gardnerella for decades. Cases regarding the clinical relevance of Gardnerella leopoldii have rarely been reported, which is crucial for fully understanding the various species within the genus Gardnerella.Case presentationA 72-year-old female patient was admitted to the hospital with gross hematuria and complaints of waist soreness. Physical examinations, including those of the head, chest, and abdomen, along with routine laboratory tests such as white blood cell (WBC) count and proportion, liver function, and renal function, yielded normal results. However, the patient also exhibited significantly elevated levels of serum C-reactive protein (CRP) and abnormal urinary test findings, which revealed positive results for occult blood and leukocyte esterase, and increased counts of erythrocyte and leukocyte. To further evaluate the urinary system, computerized tomography urography (CTU) was performed. The CTU results revealed multiple weakly enhanced foci in the right kidney and thickening of the right ureter, renal pelvis, calyces, and bladder walls. Based on the above findings, the initial diagnosis included hematuria, hydronephrosis, and urinary tract infection (UTI). To identify the causative pathogens, we employed a comprehensive approach that included microscopic morphology, Sanger sequencing, and metagenomic next-generation sequencing (mNGS). Finally, both Mycobacterium tuberculosis and G. leopoldii were identified as the co-infecting etiological agents responsible for the patient’s urinary tract infection.ConclusionThis case represents the first documented isolation of clinically relevant G. leopoldii, guided by morphological and molecular evidence from a clinical urine sample. It highlights the potential of mNGS as a promising tool for identifying previously unrecognized species and offers valuable insights to enhance the understanding of clinically relevant microorganisms.https://www.frontiersin.org/articles/10.3389/fmed.2025.1548067/fullurinary tract infection (UTI)Gardnerella leopoldiimetagenomic next-generation sequencing (mNGS)microscopic morphologycase report
spellingShingle Liangyou Chen
Liangyou Chen
Wei Weng
Dan Li
Weipeng Xie
Lingling Lu
Shuo Li
Shuo Li
Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
Frontiers in Medicine
urinary tract infection (UTI)
Gardnerella leopoldii
metagenomic next-generation sequencing (mNGS)
microscopic morphology
case report
title Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
title_full Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
title_fullStr Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
title_full_unstemmed Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
title_short Case Report: A clinically relevant isolation of Gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
title_sort case report a clinically relevant isolation of gardnerella leopoldii guided by morphological and molecular evidence from a urinary tract infection case
topic urinary tract infection (UTI)
Gardnerella leopoldii
metagenomic next-generation sequencing (mNGS)
microscopic morphology
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1548067/full
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