{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:40:52Z","timestamp":1780659652487,"version":"3.54.1"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Necrotizing pneumonia and empyema caused by\n                    <jats:italic>Fusobacterium necrophorum<\/jats:italic>\n                    are uncommon. The classical presentation of Lemierre\u2032s syndrome, characterized by pharyngotonsillitis and internal jugular vein thrombosis, is not always observed, and incomplete and atypical variants can cause diagnostic uncertainty and delay in treatment. We describe the case of a previously healthy 22\u2010year\u2010old male athlete who developed severe necrotizing community\u2010acquired pneumonia, bilateral empyema, and acute hypoxemic respiratory failure due to\n                    <jats:italic>F. necrophorum<\/jats:italic>\n                    infection, without the typical vascular thrombosis associated with Lemierre\u2032s syndrome. Blood cultures and broad\u2010range PCR analysis of the empyema fluid confirmed the presence of\n                    <jats:italic>F. necrophorum<\/jats:italic>\n                    . The patient was initially treated with piperacillin\u2013tazobactam, intravenous corticosteroids, and bilateral chest tube placement for empyema management. Treatment with piperacillin\u2013tazobactam was complicated by drug\u2010induced liver injury requiring antimicrobial change to ampicillin\u2013sulbactam. The patient was discharged on oral amoxicillin\u2013clavulanic acid and completed a total of 5 weeks of antimicrobial therapy with complete recovery. This case highlights the importance of considering\n                    <jats:italic>F. necrophorum<\/jats:italic>\n                    as a potential pathogen in necrotizing community\u2010acquired pneumonia, even in immunocompetent adults, and in the absence of classic Lemierre\u2032s syndrome features. Furthermore, its novelty and contribution to the medical literature stem from the patient\u2032s presentation with bilateral empyema requiring bilateral drains, the combined blood culture and pleural fluid 16S confirmation of\n                    <jats:italic>F. necrophorum<\/jats:italic>\n                    infection, and the preceding steroid exposure that contributed to clinical deterioration.\n                  <\/jats:p>","DOI":"10.1155\/crpu\/5505327","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T10:23:26Z","timestamp":1768386206000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Severe Necrotizing Community\u2010Acquired Pneumonia and Bilateral Empyema in an Immunocompetent Patient due to\n                    <i>Fusobacterium 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