Table 3.

Samples from Patients with Low Clinical Suspicion for Infection and Negative Targeted Metagenomic Sequencing (tMGS)

tMGS	Culture	Antibiotics	Clinical Background
Negative	Negative	Piperacillin/tazobactam + vancomycin	Suspected malignant effusion vs infection, cytology was positive for adenocarcinoma. Previous week had pneumonia treated with broad-spectrum antibiotics. Low suspicion of infected pleural space.
Negative	Not obtained	Vancomycin	Thoracoabdominal aortic aneurysm repair and pigtail catheter 7 d before symptomatic effusion. Culture then grew Staphylococcus epidermidis. Pigtail catheter was placed again for symptom control. Low suspicion of infected pleural space.
Negative	Negative	Ceftriaxone + azithromycin	Community-acquired pneumonia suspected; patient dismissed on levofloxacin. Likely parapneumonic effusion. Low suspicion of infected pleural space.
Negative	Negative	Cefepime + metronidazole	Suspected aspiration, bronchial washes negative for bacterial infection but devoid of secretions. Low suspicion of infected pleural space.
Negative	Negative	Cefepime + Metronidazole + vancomycin	Suspected malignant effusion vs infection, in the setting of metastatic ileocecal adenocarcinoma.
Negative	Negative	Cefepime + metronidazole + vancomycin	Cytology was positive for adenocarcinoma. Antibiotics stopped after 24 hours. Low suspicion of infected pleural space.