Fusobacterium spp. are Gram-negative, obligate anaerobic bacteria associated with a broad clinical spectrum, including head and neck infections; soft tissue infections; gastrointestinal and genitourinary infections; and bacteremia without an identified source. Clinical manifestations vary by species and site of colonization. F. necrophorum is linked to head and neck infections that may culminate in Lemierre syndrome, a life-threatening septic thrombophlebitis of the internal jugular vein. Although Fusobacterium bacteremia is uncommon, it is associated with substantial mortality. F. necrophorum bacteremia may occur as a complication of head and neck infection in younger, healthy individuals, whereas F. nucleatum bacteremia is reported predominantly in older patients with malignancy, secondary to an abdominal source or without an identified origin. Fusobacterium isolates are usually susceptible to penicillins, cephalosporins, aminopenicillins with β-lactamase inhibitors, carbapenems, and metronidazole, while resistance to clindamycin and moxifloxacin has been increasingly reported. Because susceptibility testing is not routinely performed and susceptibility data remain limited, severe infections are commonly treated with a β-lactam/β-lactamase inhibitor, a carbapenem, or a β-lactam in combination with metronidazole. This review provides an overview of the microbiology, clinical spectrum, and treatment of Fusobacterium spp.

This study explores the value of targeted next-generation sequencing (tNGS) in the etiological diagnosis of unexplained pneumonia in elderly patients. A 76-year-old male patient presenting with fever and cough was initially diagnosed with lobar pneumonia. Bronchoalveolar lavage fluid (BALF) was analyzed using tNGS, which detected Coxiella burnetii (4 sequences), confirming the diagnosis. Treatment with moxifloxacin and doxycycline led to significant symptom improvement and complete resolution of pulmonary lesions on imaging. The results demonstrate that tNGS can provide rapid and accurate diagnosis of Coxiella burnetii pneumonia, offering important clinical insights.

Tuberculosis remains the biggest global killer from infectious causes, with an estimated 1.25 million deaths per year. The quadruple drug regimen of rifampicin, isoniazid, pyrazinamide, and ethambutol has been standard therapy for 40 years, with good outcomes in patients with drug susceptible tuberculosis who are able to tolerate the drug regimen. However, the frequency of adverse drug reactions and emergence of drug resistant tuberculosis has created demand for new treatment strategies: there is now a surge in novel tuberculosis agents and regimens entering human trials. For decades, drug resistant tuberculosis required at least 18 months of second line and third line combination treatments that included injectable agents. In 2022, in response to a growing body of trial evidence, the World Health Organization (WHO) introduced six month and nine month all oral regimens for pulmonary drug resistant tuberculosis in specific settings. These encompass agents in the bedaquiline-pretomanid-linezolid/moxifloxacin regimen, as well as repurposed and novel agents such as clofazimine and delamanid. In addition, a large number of novel antimicrobial and host directed treatments are progressing to late stage clinical trials for tuberculosis, raising the prospect of shorter, more efficacious, and better tolerated treatments. This review summarises the agents and regimens recommended in the latest consolidated WHO treatment guidelines for tuberculosis (2025), including a synopsis of the evidence base for their safety, efficacy, and cost effectiveness. It also outlines the antimicrobial and host directed treatments that have entered phase 2-4 clinical trials for pulmonary tuberculosis in adults.