{
  "abstract": "An immunocompetent adolescent male presented with severe tonsillitis that rapidly progressed to a life-threatening upper airway obstruction requiring intensive care. Initial empirical antibiotics were ineffective. Sputum culture isolated Raoultella ornithinolytica, a rare environmental pathogen. Treatment was commenced and titrated based on sensitivities leading to a full recovery. This case establishes R. ornithinolytica as a cause of severe obstructive tonsillitis in healthy immunocompetent individuals. It highlights crucial learning points: clinicians should consider emerging environmental pathogens in severe tonsillitis especially with relevant exposure history. Microbiological sampling is critical in atypical or treatment-refractory cases to guide therapy. Additionally, the use of modern diagnostic methods is essential for accurately identifying such uncommon pathogens, ensuring appropriate antimicrobial stewardship.",
  "authors": [
    {
      "affiliations": [
        "ENT, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK",
        "University of Warwick, Coventry, UK"
      ],
      "name": "José Maria Pereira Marques Leal"
    },
    {
      "affiliations": [
        "ENT, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"
      ],
      "name": "Emma Elizabeth Hoskison"
    }
  ],
  "title": "Life-threatening obstructive tonsillitis caused by Raoultella ornithinolytica in an immunocompetent adolescent",
  "uid": "f66fbd9d-bd94-5296-bee5-8b42fda5b81e"
}