Streptococcus Pharyngitis with Anaerobes Infection Misdiagnosed as Mycobacterium Tuberculosis Infection: A Case Report

Introduction: Pulmonary infection is a common disease in respiratory department. Different pathogens may lead to the same clinical symptoms and imaging changes, and the same pathogen may also lead to different clinical symptoms and imaging changes. It is often difficult to identify specific pathogens in pulmonary infection. Sometimes the patient’s condition is delayed due to the doctor’s inability to judge the specific pathogen well and the failure to carry out targeted treatment. We share this case and hope that doctors can enhance their understanding of this disease, minimize misdiagnosis and enhance the accuracy of disease diagnosis. Case report: This case reported a patient with recurrent fever, which was misdiagnosed as Mycobacterium tuberculosis infection and developed high fever after diagnostic anti-tuberculosis treatment. The posterior pleural effusion next-generation sequencing (NGS) confirmed that the patient was empyema caused by streptococcus pharyngitis combined with anaerobic infection. After anti-infection with teicoplanin and levofloxacin, the patient's body temperature was normal, lung shadow and pleural effusion were completely absorbed. Discussion/Conclusions: In clinical work, we should be vigilant against false positive T cell spot test (T-SPOT.TB), make rational use of NGS and other detection methods, identify specific pathogens as soon as possible, and carry out reasonable targeted treatment.