两面神菌属为罕见的革兰氏阳性棒状细菌，主要存在于环境中，该细菌可引发菌血症，甚至可能进一步发展为脓毒症，加重临床症状。2022年5月，1例9岁男性患儿因“间断发热1月余”收治入本院，查体示全身散在出血性皮疹，耳后明显；双侧颈部、左锁骨上窝及双侧腋下可触及多发肿大淋巴结，约蚕豆大小，质地韧，活动度尚可，无触痛。血常规示白细胞计数2.79×10⁹/L↓，C反应蛋白6.41 mg/L↑，降钙素原0.2 ng/mL↑。粪便常规潜血阳性，天冬氨酸氨基转移酶65.6 U/L↑，丙氨酸氨基转移酶60 U/L↑、乳酸脱氢酶480 IU/L↑、肌酸激酶同工酶30.7 U/L↑。宏基因组二代测序（mNGS）示两面神菌属细菌，序列数408。遂患儿明确诊断为两面神菌属细菌感染，经免疫球蛋白、利奈唑胺和复方磺胺甲噁唑治疗后临床症状好转，各项实验室检查正常，mNGS复查未找到病原菌。该患儿为国内外首例由柠檬两面神菌感染引起脓毒症的儿童病例。

The genus Janibacter is a rare Gram-positive rod-shaped bacterium that mainly exists in the environment. This bacterium can cause bacteremia and may further develop into sepsis, aggravating clinical symptoms. In May 2022, a 9-year-old boy was admitted to our hospital due to "intermittent fever for over one month." Physical examination revealed scattered hemorrhagic rashes over the body, with notable involvement of the postauricular area. Multiple enlarged lymph nodes can be palpated bilaterally in the neck, in the left supraclavicular fossa and bilaterally in the axillae, approximately the size of broad beans, with a firm texture, fair mobility and no tenderness on palpation. Laboratory tests showed a white blood cell count of 2.79×10⁹/L↓, C-reactive protein of 6.41 mg/L↑, and procalcitonin of 0.2 ng/mL↑. Fecal occult blood was positive. Laboratory examinations revealed elevated levels of aspartate aminotransferase (65.6 U/L↑), alanine aminotransferase (60 U/L↑), lactate dehydrogenase (480 IU/L↑), and creatine kinase isoenzyme (30.7 U/L↑). Metagenomic next-generation sequencing (mNGS) identified Janibacter, with 408 sequences detected. The child was definitively diagnosed with Janibacter infection. After treatment with intravenous immunoglobulin, linezolid, and co-trimoxazole, the clinical symptoms improved, laboratory tests normalized, and no pathogens were detected on follow-up mNGS. This child represents the first reported pediatric case of sepsis caused by Janibacter melonis infection, both domestically and internationally.