PMC9651478_01
Timeline of the clinical course and duration of treatment.
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F1
At that time, he was treated with amoxicillin clavulanate potassium for 4 days and with levofloxacin for 6 days (Figure 1).
Serial chest computed tomography (CT) scans of the patient with Parvimonas micra pneumonia. (A-C) The initial CT scan on 9 March 2022 (2 days after symptom onset) shows subpleural nodules in both lungs, some nodules with ground glass appearance, and a few exudative inflammatory lesions in both lower lungs. (D-F) A CT on the next day (10 March 2022) showed more nodules and exudative lesions in both lungs and some enlarged nodules. (G-I) A follow-up scan (21 March 2022) after treatment with amoxicillin clavulanate potassium and levofloxacin showed multiple subpleural nodules with newly emerged bilateral pleural effusion and an exudative lesion in the right lung. (J-L) Another CT (4 April 2022) showed complete absorption of the pleural effusion and a reduced exudative lesion. (M-O) Another CT after moxifloxacin treatment for 3 months (15 June 2022) exhibited an almost normal chest image.
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F2
As shown in Figure 2, consecutive CT images showed an increasing number of nodules and exudative inflammatory lesions with a newly emerged pleural effusion. Fortunately, a follow-up chest CT on 4 April 2022 showed complete absorption of pleural fluid and significant resolution of the exudative lesions (Figure 2). Finally, a chest CT on 15 June 2022 showed almost total resolution of the lung lesion (Figure 2).
Comparison of the oral and lung microbiome (heatmap). (A) No significant differences were found in P. micra between oral wash and BALF samples (0.11% in BALF vs. 0.13% in oral wash). (B,C) The alpha diversity of the oral microbiome comparing the patient to a healthy man. Both the Chao1 and Shannon indexes were lower in the patient (Chao1: 986 vs. 3,079, Shannon index: 4.244 vs. 4.829).
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F3
Interestingly, the results identified Parvimonas not only in the oral cavity but also in the BALF (Figure 3). Compared to the oral flora of healthy men, the patient's alpha diversity of the oral cavity was significantly reduced (Figure 3).