• Yanjing Huang, Hongkun Guo, and Yiming Li.
• Department of Emergency, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
• Medicine (Baltimore). 2024 Sep 6; 103 (36): e39571e39571.

RationaleStreptococcus pneumoniae is a common cause of community-acquired pneumonia. Currently, it is believed that many cases of pulmonary infection with negative results on pathogenic testing are caused by S. pneumoniae. There have been no reports of the detection of S. pneumoniae antigen in lung lavage fluid.Patient ConcernsAn elderly male patient with suboptimal fasting blood glucose control and a history of liver abscess.DiagnosisChest computed tomography (CT) revealed inflammatory lesions in both lungs with consolidation in the middle lobe of the right lung.InterventionsAfter admission, we collected alveolar lavage fluid in a timely manner and performed pneumococcal antigen detection and etiological testing.OutcomesPrompt testing for pneumococcal antigen in bronchoalveolar lavage fluid yielded a positive clinical outcome. Subsequent analysis via bacterial culture of sputum and next-generation sequencing (mNGS) of BALF definitively identified S. pneumoniae as the etiological agent. Following the analysis of drug sensitivity test results from the identified pathogens, adjustments were made to the antibiotic regimen, and appropriate pus puncture drainage was performed. Subsequently, the patient's condition improved, leading to discharge.ConclusionThe identification of S. pneumoniae antigen in bronchoalveolar lavage fluid may facilitate earlier and more precise diagnosis of pneumonia attributed to S. pneumoniae.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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