{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:36:27Z","timestamp":1768466187781,"version":"3.49.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"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. Med."],"abstract":"<jats:p>Severe infections that develop rapidly from ordinary symptoms not only increase patient misunderstandings but also lead to excessive detection of these symptoms by physicians. This case study describes a 19-year-old male individual who initially presented with a sore throat and subsequently developed multiple serous cavity effusions that lead to septic pulmonary embolism and septic shock. After multiple cultures of the patient\u2019s sputum yielded no identifiable pathogenic bacteria, the metagenomic next-generation sequencing (mNGS) revealed <jats:italic>Prevotella oris<\/jats:italic> as the predominant pathogen present in both the patient\u2019s peripheral blood and the pericardial drainage fluid. The subsequent antibiotic treatment, guided by the mNGS results, along with surgical drainage and mediastinal irrigation, effectively controlled and ultimately cured the patient\u2019s condition. This case is unique because it is the first to show that normally colonizing <jats:italic>Prevotella<\/jats:italic> can also cause fatal multiorgan infection as an opportunistic pathogen in a previously healthy young person with no immune-related diseases. The aim of this study is to expand clinical awareness of this common symptom and its potentially fatal outcome.<\/jats:p>","DOI":"10.3389\/fmed.2025.1517389","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T05:25:59Z","timestamp":1738128359000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["When a sore throat turns into deadly multiple serous cavity effusions: the role of Prevotella oris in rapidly progressing infection\u2014a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Fangqi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan-Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaokui","family":"Si","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Yue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.chom.2019.08.018","article-title":"The Prevotella copri complex comprises four distinct clades underrepresented in westernized populations","volume":"26","author":"Tett","year":"2019","journal-title":"Cell Host Microbe"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1093\/infdis\/jiad261","article-title":"Prevotella and Gardnerella are associated with treatment failure following first-line antibiotics for bacterial vaginosis","volume":"228","author":"Plummer","year":"2023","journal-title":"J Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1080\/14737175.2019.1555473","article-title":"Microbial monotherapy with Prevotella histicola for patients with multiple sclerosis","volume":"19","author":"Mangalam","year":"2019","journal-title":"Expert Rev Neurother"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"102644","DOI":"10.1016\/j.anaerobe.2022.102644","article-title":"Prevotella oris: A lesser known etiological agent of pleural effusion","volume":"78","author":"Viswanath","year":"2022","journal-title":"Anaerobe"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"503","DOI":"10.37201\/req\/046.2022","article-title":"Two rare cases of pleural infection due to Prevotella species","volume":"35","author":"Cobo","year":"2022","journal-title":"Rev Esp Quimioter"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1186\/s13019-024-02764-1","article-title":"Chylous leakage after esophagectomy for esophageal cancer: a systematic review","volume":"19","author":"Zheng","year":"2024","journal-title":"J Cardiothorac Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"108884","DOI":"10.1016\/j.ijscr.2023.108884","article-title":"Successful surgical treatment of congenital chylous ascites co-existed with congenital hypothyroidism: A rare case report","volume":"111","author":"Roumi Jamal","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e22560","DOI":"10.7759\/cureus.22560","article-title":"Chylous ascites secondary to retroperitoneal Para-aortic lymphadenectomy: a case report","volume":"14","author":"Gil Gonz\u00e1lez","year":"2022","journal-title":"Cureus"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1002\/ncp.10973","article-title":"Chylothorax and chylous ascites: overview, management, and nutrition","volume":"38","author":"Duletzke","year":"2023","journal-title":"Nutr Clin Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"20220596","DOI":"10.1515\/biol-2022-0596","article-title":"Prostatitis as initial manifestation of Chlamydia psittaci pneumonia diagnosed by metagenome next-generation sequencing: a case report","volume":"18","author":"Li","year":"2023","journal-title":"Open Life Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40168-016-0160-7","article-title":"Interpreting Prevotella and Bacteroides as biomarkers of diet and lifestyle","volume":"4","author":"Gorvitovskaia","year":"2016","journal-title":"Microbiome."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1169476","DOI":"10.3389\/fmicb.2023.1169476","article-title":"Characterization of microbial community and antibiotic resistome in intra urban water","volume":"14","author":"Ye","year":"2023","journal-title":"Wenzhou China Front Microbiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1047607","DOI":"10.3389\/fcimb.2022.1047607","article-title":"The oral microbiome in young women at different stages of periodontitis: Prevotella dominant in stage III periodontitis","volume":"12","author":"Zhao","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/imm.12760","article-title":"The immune response to Prevotella bacteria in chronic inflammatory disease","volume":"151","author":"Larsen","year":"2017","journal-title":"Immunology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40168-016-0222-x","article-title":"Gut microbiota dysbiosis contributes to the development of hypertension","volume":"5","author":"Li","year":"2017","journal-title":"Microbiome"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2079814","DOI":"10.1080\/20002297.2022.2079814","article-title":"Prevotella species as oral residents and infectious agents with potential impact on systemic conditions","volume":"14","author":"K\u00f6n\u00f6nen","year":"2022","journal-title":"J Oral Microbiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"105714","DOI":"10.1016\/j.archoralbio.2023.105714","article-title":"Symbiotic relationship between Prevotella denticola and Streptococcus mutans enhances virulence of plaque biofilms","volume":"151","author":"Niu","year":"2023","journal-title":"Arch Oral Biol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.3390\/jcm8091339","article-title":"Importance of virulence factors for the persistence of Oral Bacteria in the inflamed gingival crevice and in the pathogenesis of periodontal disease","volume":"8","author":"Dahlen","year":"2019","journal-title":"J Clin Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.3390\/microorganisms10081574","article-title":"Consortium of indigenous fecal Bacteria in the treatment of metabolic syndrome","volume":"10","author":"Ermolenko","year":"2022","journal-title":"Microorganisms"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1164\/rccm.202205-0893OC","article-title":"Microbial dysregulation of the gut-lung Axis in bronchiectasis","volume":"207","author":"Narayana","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s12663-020-01401-3","article-title":"Odontogenic infection pathway to the Parapharyngeal space: CT imaging assessment","volume":"21","author":"Ogura","year":"2022","journal-title":"J Maxillofac Oral Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1056\/NEJMicm1808378","article-title":"Lemierre's Syndrome","volume":"380","author":"Walkty","year":"2019","journal-title":"N Engl J Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.anaerobe.2010.12.005","article-title":"Development of Prevotella nigrescens-specific PCR primers based on the nucleotide sequence of a Pn23 DNA probe","volume":"17","author":"Kim","year":"2011","journal-title":"Anaerobe"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1186\/s12883-023-03374-5","article-title":"Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing","volume":"23","author":"Ye","year":"2023","journal-title":"BMC Neurol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/1471-2180-14-196","article-title":"The Unculturables: targeted isolation of bacterial species associated with canine periodontal health or disease from dental plaque","volume":"14","author":"Davis","year":"2014","journal-title":"BMC Microbiol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1414000","DOI":"10.3389\/fmicb.2024.1414000","article-title":"Temporal dynamics and species-level complexity of Prevotella spp. in the human gut microbiota: implications for enterotypes and health","volume":"15","author":"Han","year":"2024","journal-title":"Front Microbiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2218","DOI":"10.3390\/diagnostics12092218","article-title":"Analysis of the causes of solitary pulmonary nodule misdiagnosed as lung Cancer by using artificial intelligence: a retrospective study at a single center","volume":"12","author":"Wu","year":"2022","journal-title":"Diagnostics"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"S224","DOI":"10.1093\/clinids\/20.supplement_2.s224","article-title":"A retrospective review of cases of anaerobic empyema and update of bacteriology","volume":"20","author":"Civen","year":"1995","journal-title":"Clin Infect Dis"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1517389\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T05:26:02Z","timestamp":1738128362000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1517389\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,29]]},"references-count":28,"alternative-id":["10.3389\/fmed.2025.1517389"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1517389","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,29]]},"article-number":"1517389"}}