Zang DY, Li LG, Yang SG, Wang YY, Yu XQ. Combination of next-generation sequencing and traditional examinations for identifying Leuconostoc garlicum: A case report. World J Clin Cases 2025; 13(24): 105923 [DOI: 10.12998/wjcc.v13.i24.105923]
Corresponding Author of This Article
Xue-Qing Yu, Chief Physician, MD, Professor, Department of Respiratory, The First Affiliated Hospital of Henan University of CM, No. 19 Renmin Road, Zhengzhou 450000, Henan Province, China. yxqshi@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dan-Yang Zang, Lu-Guang Li, Shu-Guang Yang, Xue-Qing Yu, Department of Respiratory, The First Affiliated Hospital of Henan University of CM, Zhengzhou 450000, Henan Province, China
Yuan-Yuan Wang, Department of Bronchoscopy, The First Affiliated Hospital of Henan University of CM, Zhengzhou 450000, Henan Province, China
Co-first authors: Dan-Yang Zang and Lu-Guang Li.
Author contributions: Zang DY and Li LG contributed equally to this study as co-first authors. These two authors made equal significant contributions to the work and share equal responsibility and accountability for it. Zang DY and Yu XQ contributed to planning the diagnosis and treatment; Yang SG and Wang YY collected histopathological data; Zang DY organized the data and created the figures; Li LG drafted the manuscript; All authors contributed to manuscript revision and have read and approved the version for publication.
Informed consent statement: Informed written statement was obtained from the patient for publication of this report.
Conflict-of-interest statement: All the authors have approved this study, and there are no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Qing Yu, Chief Physician, MD, Professor, Department of Respiratory, The First Affiliated Hospital of Henan University of CM, No. 19 Renmin Road, Zhengzhou 450000, Henan Province, China. yxqshi@163.com
Received: February 11, 2025 Revised: April 12, 2025 Accepted: May 10, 2025 Published online: August 26, 2025 Processing time: 125 Days and 16.4 Hours
Abstract
BACKGROUND
Leuconostoc garlicum is commonly found in fermented foods and very few infected patients have been reported, who typically present symptoms such as fever and fatigue. Conventional clinical examinations often struggle to identify this bacterium, and routine anti-infective treatments are generally ineffective. Both diagnostic challenges and therapeutic limitations pose significant difficulties for clinicians.
CASE SUMMARY
We report a patient ultimately diagnosed with Leuconostoc garlicum infection. The primary manifestations included persistent fever, cough and fatigue. These symptoms lasted for 2 months. He received anti-infective treatment at a community hospital, but this was ineffective. After inquiring about the patient's medical history and conducting a physical examination, the patient underwent laboratory tests. Complete blood count tests revealed that the patient had a high proportion of neutrophils, C-reactive protein level was 235.9 mg/L, erythrocyte sedimentation rate was 67 mm/h, respiratory pathogen testing was negative, and he was then thought to have an infectious disease. However, conventional anti-infective treatments were ineffective. After excluding infectious neurological diseases, urologic diseases and digestive problems, we ultimately focused our attention on the lungs. A lung computed tomography scan indicated pulmonary inflammation. Bronchoalveolar lavage fluid for next-generation sequencing suggested lung infection with Leuconostoc garlicum. The patient's symptoms gradually improved following treatment with piperacillin tazobactam and linezolid. During the follow-up period, the patient's temperature remained normal.
CONCLUSION
For patients with suspected bacterial infection and experiencing fever, conventional anti-infective treatment can be ineffective in controlling their symptoms, and an infection due to rare bacteria or drug-resistant bacteria should be considered. Next-generation sequencing enables rapid and precise identification of infection-related pathogens in febrile patients.
Core Tip: We report a case of Leuconostoc garlicum infection with persistent fever accompanied by fatigue. For patients with fever of unknown origin as the primary manifestation, comprehensive physical examination and thorough medical history are essential to minimize the risk of a missed or incorrect diagnosis. For most patients with fever caused by infection, conventional anti-infective treatment can lead to recovery. However, special attention should be paid to patients with rare or drug-resistant bacterial infections, whose diagnosis and treatment may be more difficult. Next-generation sequencing technology may provide support for the diagnosis and treatment of these patients.
