Fatal sepsis case and finding of Clostridium perfringens infection diagnosed by next- generation sequencing: A case report and literature review.

We report a case of acute cholangitis (AC) with associated bacteremia in a 45-year-old patient admitted to Mae Sot General Hospital, a secondary-care level hospital, in Thailand. The anaerobic bacteria, Clostridium perfringens, was missed by routine blood culture but detected by 16S rRNA gene-targeted next-generation sequencing (NGS). Due to the limitation of blood culture for the detection of anaerobic bacteria, implementing culture-independent NGS methods can improve the diagnosis of infection and provide necessary information for patient management. This report describes the case's clinical course and treatment and highlights the importance of NGS in identifying difficult-to-culture bacteria causing fatal human diseases.