{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:24:00Z","timestamp":1787059440598,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    Since its formal description in 2016,\n                    <jats:italic>Lawsonella clevelandensis<\/jats:italic>\n                    \u2014a strictly anaerobic, partially acid-fast bacterium\u2014has been increasingly recognized as a cause of deep-seated abscesses, yet its fastidious nature and absence from routine diagnostic databases contribute to significant underdiagnosis. This narrative review synthesizes current knowledge on its microbiology, expanding clinical spectrum, diagnostic strategies, and treatment, based on a literature search of PubMed and Web of Science up to April 2026. Analysis of 27 documented publications, comprising 18 clinical cases, reveals a potential association with host risk factors including diabetes, immunosuppression, and prior surgical procedures, alongside a notable predilection for fat-rich tissues such as the breast and abdomen. While metagenomic next-generation sequencing and 16S rRNA gene amplification have become indispensable for definitive identification, antimicrobial susceptibility data\u2014derived primarily from a single strain\u2014demonstrate uniformly low minimum inhibitory concentrations for penicillins, carbapenems, clindamycin, and metronidazole, with no acquired resistance genes identified by whole-genome sequencing. However, the absence of established clinical breakpoints and limited tested isolates precludes definitive conclusions about universal susceptibility. Clinicians should maintain a high index of suspicion for\n                    <jats:italic>L. clevelandensis<\/jats:italic>\n                    in culture-negative deep abscesses, particularly those with acid-fast rods, as prompt diagnosis and empirical therapy with \u03b2-lactam\/\u03b2-lactamase inhibitors or carbapenems appear reasonable based on current\n                    <jats:italic>in vitro<\/jats:italic>\n                    and clinical evidence, though further susceptibility surveillance is essential.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2026.1914466","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:24:52Z","timestamp":1787055892000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lawsonella clevelandensis: a normal flora that bites deep"],"prefix":"10.3389","volume":"16","author":[{"given":"Yun","family":"Jin","sequence":"first","affiliation":[{"name":"Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province","place":["Nanchang, China"]},{"name":"JXHC Key Laboratory of Skin Infection and Immunity, The Affiliated Dermatology Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxiao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Evidence-Based Medicine Research Center, Mass Spectrometry Research Center for Diagnosis, Treatment, and Chronic Disease Rehabilitation, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangmin","family":"Gao","sequence":"additional","affiliation":[{"name":"Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province","place":["Nanchang, China"]},{"name":"JXHC Key Laboratory of Skin Infection and Immunity, The Affiliated Dermatology Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianfeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Evidence-Based Medicine Research Center, Mass Spectrometry Research Center for Diagnosis, Treatment, and Chronic Disease Rehabilitation, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Tao","sequence":"additional","affiliation":[{"name":"Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province","place":["Nanchang, China"]},{"name":"JXHC Key Laboratory of Skin Infection and Immunity, The Affiliated Dermatology Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1099\/acmi.0.000183","article-title":"Lawsonella clevelandensis is a rare cause of infected chronic contained rupture of abdominal aortic aneurysm","volume":"3","author":"Ahmed","year":"2021","journal-title":"Access Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2929","DOI":"10.1099\/ijsem.0.001122","article-title":"Lawsonella clevelandensis gen. nov. sp. nov. a new member of the suborder Corynebacterineae isolated from human abscesses","volume":"66","author":"Bell","year":"2016","journal-title":"Int. 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