PMC6258366_01
CT images indicate bronchodilation, thickness of the bronchial wall, centrilobular granular shadow, and consolidation in the lingular and right S8 segments (A). Both of these lesions became worse when the patient suffered hemoptysis (B) and then improved after antibiotic treatment.
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Chest computed tomography (CT) revealed worsened bronchodilation, bronchial wall thickness, centrilobular nodules, and air-space consolidation in the lower right lobe and lingula (Fig. 1A). While waiting for the rRNA sequencing analysis results, the patient suffered worsened hemoptysis and was readmitted to our hospital in October (Fig. 1B). After antibiotic therapy, the lower right lobe and lingular shadows were extremely improved (Fig. 1C).
Bronchoscopy indicates a large amount of purulent sputum from the lingular segments (A). Gram staining revealed gram-negative rods in the bronchial wash specimen (B). Phylogenetic relationship of the Pasteurella species isolated from the culture (C). The partial 16S rRNA gene sequences from culture isolates were compared with the GenBank database using BLAST searches. In 1354 base pairs of the 16S rRNA gene sequences, the isolates showed a 99.9% identity match with the GenBank sequence M75052 (P. multocida subsp. septica). Bar = 0.5% sequence divergence.
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A large amount of purulent sputum was observed in the lingular segments (Fig. 2A). Cultures of wash specimens from the right B8a and lingular segments revealed gram-negative rods (Fig. 2B), which using Vitek 2 testing, were identified as P. canis with a 91% identification probability. Because P. canis quite rarely causes pneumonia, we performed 16S ribosomal RNA (rRNA) sequencing for confirming the diagnosis; the isolates were identified as P. multocida subsp. septica with a 99.9% probability (Fig. 2C).