Rare case of Spherical pneumonia caused by Ralstonia mannitolilytica: A report
Researchers have reported a rare case of Spherical pneumonia caused by Ralstonia mannitolilytica. According to them when spherical pneumonia is difficult to diagnose, mNGS may be a better alternative. The case has been published in the BMC Pulmonary Medicine.
Spherical pneumonia is a rare and specific type of lung inflammation that most commonly presents as a round or round-like mass shadow on imaging . It is difficult to diagnose clinically and is often misdiagnosed as lung cancer. The clinical presentation of spherical pneumonia is atypical; patients may have respiratory symptoms such as fever, cough, sputum, hemoptysis, and chest pain, or they may have no symptoms and are often discovered by physical examination. Therefore awareness of this disease is important and must be strengthened.
The patient was a 29-year-old female who had persistent cough and sputum for approximately 1 month and fever for 5 days. Chest computed tomography (CT) at our hospital revealed a mass in the lower lobe of the right lung near the hilar region, with obstructive pulmonary atelectasis and obstructive pneumonia. Although lung cancer was suspected, Ralstonia mannitolilytica was detected by metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid, and no cancer cells or Mycobacterium tuberculosis were detected. Finally, the patient was diagnosed with spherical pneumonia caused by R. mannitolilytica. Anti-infective treatment, symptomatic treatment, and administration of a traditional Chinese medicine decoction were performed based on the syndrome differentiation. After 10 days of treatment, chest CT revealed few lesions in the lower lobe of the right lung, which were significantly reduced compared with those in the past.
Spherical pneumonia caused by R. mannitolilytica has not yet been reported and differential diagnosis is key in clinical diagnosis. When spherical pneumonia is difficult to diagnose, mNGS may be a better alternative.
Ma, J., Zhang, C., Dang, K. et al. Spherical pneumonia caused by Ralstonia mannitolilytica: a case report and literature review. BMC Pulm Med 23, 20 (2023). https://doi.org/10.1186/s12890-023-02316-8
