case_images: PMC10904578_01
case_images: The patient's oropharynx showed a markedly swollen bilateral tonsil with white, purulent exudates.
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case_images: The oropharynx showed a markedly swollen bilateral tonsil with small purulent exudates ( Figure 1 ).
case_images: 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).
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case_images: CSF were negative. Chest CT results showed multiple small patchy hyperdense shadows and nodular shadows in both lungs ( Figure 2A ), and the laryngeal pharyngeal area was slightly narrow ( Figure 2B ). Following a 14-day stay in the PICU, there was a notable improvement in the patient's condition: dependency on supplemental oxygen ceased, vital signs and infection markers normalized, and chest CT scan revealed absorption of previously observed patchy hyperdense shadows and significant reduction in nodule shadows ( Figure 2C ). The morphology of the laryngeal pharyngeal area returned to normal ( Figure 2D ).
case_images: 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).
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case_images: Meanwhile, a variety of microbes were detected by mNGS in the blood sample ( Figure 3 ).
case_images: (A) The timeline of disease progression and treatment. (B) The flowchart of the mNGS process.
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case_images: The timeline of disease progression and treatment is shown in  Figure 4A . The flow chart of the mNGS process is shown in  Figure 4B .