case_images: PMC11424430_01
case_images: Patient's treatment course and NGS sequencing results. (A) Timeline of the clinical condition progress and major management of the patient. (B) The patient's first NGS results. (C) The patient's second NGS results.
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case_images: PMC11424430_01_fmed-11-1428300-g001.jpg
case_images: F1
case_images: Figure 1 is a timeline of the clinical condition progress and major management of the patient. Chlamydia abortus infection (sequence number: 6286, relative abundance: 84.45%, gene coverage: 51.17%) (Figure 1B). Considering the significant improvement in CRP, procalcitonin, and oxygenation index, we discontinued imipenem-cilastatin sodium and switched to piperacillin-tazobactam (4.5 g every 8 h) combined with moxifloxacin (0.4g daily) for anti-infection treatment and temporarily stopped prone positioning ventilation. On the eleventh day, metagenomic next-generation sequencing results showed Chlamydia abortus infection (sequence number: 10951, relative abundance: 6.31%, gene coverage: 36.41%) (Figure 1C) combined with Corynebacterium striatum infection (sequence number: 455021, relative abundance: 74.98%), leading to a change in treatment to moxifloxacin (0.4g daily) combined with linezolid (0.6g every 12 h) for anti-infection treatment.
case_images: Patient's blood tests and imaging results during treatment. (A) Trends in white blood cell count (WBC), procalcitonin (PCT), and C-reactive protein (CRP) during hospitalization. (B) Trends in oxygenation index during hospitalization. (C) Changes in chest imaging during hospitalization. (D) Chest imaging results one month after re-examination.
case_images: fmed-11-1428300-g002.jpg
case_images: PMC11424430_01_fmed-11-1428300-g002.jpg
case_images: F2
case_images: After treatment, the patient's inflammatory markers improved (Figure 2A), oxygenation index increased (Figure 2B), lung inflammation resolved (Figure 2C), and he was successfully transferred out of the ICU on the sixteenth day of hospitalization. One month later, during a follow-up visit, his respiratory symptoms had almost disappeared, and chest imaging showed significant absorption and improvement (Figure 2D).