Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic
Prevotella is often considered a Bacteroides complex associated with a healthy plant-based diet that acts as a “probiotic” throughout the body’s entire digestive tract from the mouth to the anus. Previous studies have not reported that this “probiotic” colonizing the human body could cause severe pn...
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Frontiers Media S.A.
2024-12-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1382134/full |
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| author | Meng-Jie Li Shou-Feng Zhou Yu Zhang Yong Zhang Wen-Bo Fu |
| author_facet | Meng-Jie Li Shou-Feng Zhou Yu Zhang Yong Zhang Wen-Bo Fu |
| author_sort | Meng-Jie Li |
| collection | DOAJ |
| description | Prevotella is often considered a Bacteroides complex associated with a healthy plant-based diet that acts as a “probiotic” throughout the body’s entire digestive tract from the mouth to the anus. Previous studies have not reported that this “probiotic” colonizing the human body could cause severe pneumonia. This case report describes a 56-year-old healthy female worker with gum pain followed by fever. Despite prompt medical attention given by the use of empirical antibiotics and tooth and oral cleaning, the disease rapidly progressed to retropharyngeal abscess and severe pneumonia. Although the surgeon performed pharynx and cervical incisions and drainage, the patient’s symptoms were not significantly relieved. After repeated blood culture and sputum culture, no positive findings were found. Fortunately, Prevotella oris was found in the peripheral blood of the patient by metagenomic next-generation sequencing (mNGS). The disease was controlled quickly by changing the targeted antibiotics according to the guidelines for the detection of pathogenic bacteria. Three months after discharge, the patient’s symptoms did not resolve, and reexamination with computerized tomography (CT) showed that the neck and chest were normal. This case is unique in that it shows that normally colonized Prevotella oris could also cause fatal pneumonia as an opportunistic pathogen. Our goal is to highlight that serious infections that rapidly develop from common symptoms in an era of widespread antibiotic use not only increase patient misunderstanding but also lead to over detection and testing of such symptoms by clinicians. Expanding the pathogenic characteristics of special pathogens through the literature and using accurate mNGS may be the technical tool for resolving this contradiction. |
| format | Article |
| id | doaj-art-e8b2d2cd0d6b46f2b94d881caa55f693 |
| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-e8b2d2cd0d6b46f2b94d881caa55f6932025-08-20T02:32:37ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-12-011110.3389/fmed.2024.13821341382134Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probioticMeng-Jie Li0Shou-Feng Zhou1Yu Zhang2Yong Zhang3Wen-Bo Fu4Department of Respiratory Oncology, Renmin Hospital of Qingxian, Cangzhou, ChinaDepartment of Digestive Diseases, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, ChinaDepartment of Pathology, General Hospital of Central Theater Command of the Chinese People’s Liberation Army, Wuhan, ChinaDepartment of Integrative Medicine, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, ChinaDepartment of Cardiology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, ChinaPrevotella is often considered a Bacteroides complex associated with a healthy plant-based diet that acts as a “probiotic” throughout the body’s entire digestive tract from the mouth to the anus. Previous studies have not reported that this “probiotic” colonizing the human body could cause severe pneumonia. This case report describes a 56-year-old healthy female worker with gum pain followed by fever. Despite prompt medical attention given by the use of empirical antibiotics and tooth and oral cleaning, the disease rapidly progressed to retropharyngeal abscess and severe pneumonia. Although the surgeon performed pharynx and cervical incisions and drainage, the patient’s symptoms were not significantly relieved. After repeated blood culture and sputum culture, no positive findings were found. Fortunately, Prevotella oris was found in the peripheral blood of the patient by metagenomic next-generation sequencing (mNGS). The disease was controlled quickly by changing the targeted antibiotics according to the guidelines for the detection of pathogenic bacteria. Three months after discharge, the patient’s symptoms did not resolve, and reexamination with computerized tomography (CT) showed that the neck and chest were normal. This case is unique in that it shows that normally colonized Prevotella oris could also cause fatal pneumonia as an opportunistic pathogen. Our goal is to highlight that serious infections that rapidly develop from common symptoms in an era of widespread antibiotic use not only increase patient misunderstanding but also lead to over detection and testing of such symptoms by clinicians. Expanding the pathogenic characteristics of special pathogens through the literature and using accurate mNGS may be the technical tool for resolving this contradiction.https://www.frontiersin.org/articles/10.3389/fmed.2024.1382134/fullPrevotellagum painseptic embolinecrotizing mediastinitisLemierre’s syndrome |
| spellingShingle | Meng-Jie Li Shou-Feng Zhou Yu Zhang Yong Zhang Wen-Bo Fu Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic Frontiers in Medicine Prevotella gum pain septic emboli necrotizing mediastinitis Lemierre’s syndrome |
| title | Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic |
| title_full | Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic |
| title_fullStr | Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic |
| title_full_unstemmed | Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic |
| title_short | Unveiling the dark side of Prevotella: a case of fatal pneumonia from a common probiotic |
| title_sort | unveiling the dark side of prevotella a case of fatal pneumonia from a common probiotic |
| topic | Prevotella gum pain septic emboli necrotizing mediastinitis Lemierre’s syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1382134/full |
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