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CASE REPORT article

Front. Med.

Sec. Pulmonary Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1607223

Multimodal diagnostic approach for identifying Actinomyces Odontolyticus pneumonia: a case report and literature review

Provisionally accepted
Ya  ShenYa ShenJing-Feng  ShiJing-Feng ShiXiao-Yu  CaoXiao-Yu CaoZi-Xiao  CaoZi-Xiao CaoXiao-Bao  TengXiao-Bao Teng*Ming-Feng  HanMing-Feng Han*
  • Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, China

The final, formatted version of the article will be published soon.

The emergence of next-generation sequencing (NGS) has significantly improved the detection rate of Actinomyces species in pulmonary actinomycosis (PA), a rare and diagnostically challenging infectious disease. Here, we report a case of an elderly patient with a history of pyoderma gangrenosum who presented with pulmonary infiltrates and was subsequently hospitalized.Both histopathological examination of tracheoscopic biopsy specimens and NGS analysis of bronchoalveolar lavage fluid (BALF) confirmed infection with Actinomyces odontolyticus (A. odontolyticus). The patient exhibited marked clinical and radiological improvement following a onemonth course of amoxicillin/clavulanic acid therapy. Additionally, we performed a retrospective analysis of 11 documented cases of A. odontolyticus-associated pneumonia reported between 1978 and 2025. These cases were primarily diagnosed through pathogen culture and histopathology, with most patients demonstrating favorable outcomes following timely intervention. The age distribution of the cohort ranged from 11 to 64 years, with cough, sputum production, and dyspnea being the predominant symptoms. Notably, chest imaging findings varied widely.We anticipate that these findings will enhance clinical awareness of PA, facilitating early detection, accurate diagnosis, and improved patient management. To our knowledge, this represents the first reported case of A. odontolyticus pneumonia diagnosed using a combined NGS and histopathology approach, as well as the largest case series published for this condition.

Keywords: Actinomyces odontolyticus, Pneumonia, Next-generation sequencing, Pathology, case report

Received: 07 Apr 2025; Accepted: 12 Jun 2025.

Copyright: © 2025 Shen, Shi, Cao, Cao, Teng and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Xiao-Bao Teng, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, China
Ming-Feng Han, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, China

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