Fulminant fatal pneumonia and bacteremia due to in an immunocompetent man: a case report and literature review.

Background: is associated with soft tissue infection, bacteremia and gastroenteritis. Involvement of respiratory system in adults is extremely rare. We report a case of fulminant pneumonia and bacteremia due to in a patient without underlying diseases.

Case Presentation: A 26-year-old man became ill suddenly with pneumonia after swimming in a river. Despite intensive support measures in the intensive care unit, he died 13 hours after admission and 4 days after his first symptoms. Autopsy showed abundant Gram-negative bacteria, massive inflammatory cell infiltration, edema, necrosis and hemorrhage in lung tissue. was isolated from blood culture taken at admission and bronchoalveolar lavage fluid (BALF) after intubation. Moreover, was also detected in lung tissue by metagenomic next-generation sequencing (mNGS) assay. The infection may have come from river water.

Conclusion: In patients who develop a fulminant pneumonia after contacting an aquatic environment, should be alerted and mNGS may aid in the detection of aquatic pathogens by being more sensitive and specific versus traditional bacterial culture.