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Yeoh K, Aikeremu D, Aw-Yeong B, Slavin MA, Williams E. An Unusual and Difficult to Detect Cause of Infection in Two Trauma Patients. Clin Infect Dis 2023; 77:154-157. [PMID: 36202767 PMCID: PMC10320131 DOI: 10.1093/cid/ciac748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kim Yeoh
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
| | - Dilare Aikeremu
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Benjamin Aw-Yeong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Monica A Slavin
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
- Department of Infectious Diseases, and National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Eloise Williams
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
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2
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Xing N, Zhao Z, Li Q, Dong Y, Li J, Zhang S. Ureaplasma parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review. BMC Infect Dis 2021; 21:1276. [PMID: 34930148 PMCID: PMC8690907 DOI: 10.1186/s12879-021-06975-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background While Ureaplasma parvum has previously been linked to the incidence of chorioamnionitis, abortion, premature birth, and perinatal complications, there have only been rare reports of invasive infections of the central nervous system (CNS) in adults. Owing to its atypical presentation and the fact that it will yield sterile cultures using conventional techniques, diagnosing U. parvum meningitis can be challenging. Case presentation We describe a case of U. parvum meningitis detected in an adult patient following surgical brain tumor ablation. After operation, the patient experienced epilepsy, meningeal irritation, and fever with unconsciousness. Cerebrospinal fluid (CSF) analysis showed leukocytosis (484 * 106 /L), elevated protein levels (1.92 g/L), and decreased glucose concentrations (0.02 mmol/L). Evidence suggested that the patient was suffering from bacterial meningitis. However, no bacterial pathogens in either CSF or blood were detected by routine culture or serology. The symptoms did not improve with empirical antibiotics. Therefore, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the meningitis. Ureaplasma parvum was detected by mNGS in CSF samples. To the best of our knowledge, this case is the first reported instance of U. parvum meningitis in an adult patient in Asian. After diagnosis, the patient underwent successful moxifloxacin treatment and recovered without complications. Conclusions As mNGS strategies can enable the simultaneous detection of a diverse array of microbes in a single analysis, they may represent a valuable means of diagnosing the pathogens responsible for CNS infections and other clinical conditions with atypical presentations.
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Affiliation(s)
- Na Xing
- Department of Endocrinology, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Zhenxiang Zhao
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China.
| | - Qingjing Li
- Clinical Laboratory, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Yalan Dong
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Jianfeng Li
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Shuping Zhang
- Department of Oncology, The Seventh People's Hospital of Hebei Province, No. 389, Jungong Road, Dingzhou, 073000, Hebei, People's Republic of China
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3
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Saje A, Velnar T, Smrke B, Spazzapan P, Keše D, Kobal B, Beović B. Ureaplasma parvum ventriculitis related to surgery and ventricular peritoneal drainage. J Infect Chemother 2020; 26:513-515. [PMID: 32007385 DOI: 10.1016/j.jiac.2019.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 11/29/2022]
Abstract
Ureaplasma spp. usually causes genitourinary infections; few reports in the literature describe extragenital infections, usually in immunocompromised patients. We present a case of Ureaplasma parvum ventriculitis in an immunocompetent patient related to ventriculoperitoneal drainage and surgery. Ureaplasma parvum was detected with broad range 16S rRNA PCR and cultured on A8 agar.
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Affiliation(s)
- Andreja Saje
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia.
| | - Tomaž Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Barbara Smrke
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Peter Spazzapan
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Darja Keše
- Institute of Microbiology and Immunology Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
| | - Borut Kobal
- Department of Gynaecology, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
| | - Bojana Beović
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
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4
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A case of Ureaplasma parvum meningitis in an adult after transphenoidal ablation of craniopharyngioma. Int J Infect Dis 2019; 84:5-7. [DOI: 10.1016/j.ijid.2019.04.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022] Open
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5
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Affiliation(s)
- Søren A Ladefoged
- Department of Medical Microbiology and Immunology University of Aarhus, Denmark.,Department of Clinical Biochemistry University Hospital of Aarhus, Denmark
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6
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Barie PS. Atypical Wound Pathogens. Surg Infect (Larchmt) 2017; 18:455-460. [PMID: 28541806 DOI: 10.1089/sur.2017.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Atypical wound pathogens may be so described because they are uncommon pathogens of soft tissue among human beings, or because they may be fastidious and difficult to recover/isolate in the laboratory. METHODS A review of pertinent English-language literature was performed. RESULTS These wound pathogens are a diverse lot, including aerobic and anaerobic gram-positive and gram-negative bacilli, non-tuberculous mycobacteria, and bacteria that cannot be characterized conventionally because they lack a cell wall (the Mycoplasmataceae). They are diverse with respect to their virulence, but many are opportunistic pathogens. CONCLUSIONS Among these atypical pathogens, clinical reports are most common of wound infections caused by Mycoplasma/Ureaplasma (sometimes as co-infecting agents), and the so-called rapidly growing non-tuberculous mycobacteria (Runyon Type IV; e.g., M. chelonae).
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Affiliation(s)
- Philip S Barie
- Departments of Surgery and Medicine, Weill Cornell Medicine , New York, New York
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Lucke K, Kuster SP, Bertea M, Ruef C, Bloemberg GV. A deep sternal wound infection caused by Ureaplasma urealyticum. J Med Microbiol 2010; 59:1254-1256. [PMID: 20616189 DOI: 10.1099/jmm.0.022814-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ureaplasma species are usually associated with infection of the urogenital tract. An unusual case of a sternal wound infection caused by Ureaplasma urealyticum in a 41-year-old male after aortic valve replacement is described.
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Affiliation(s)
- Katja Lucke
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mihai Bertea
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Christian Ruef
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Guido V Bloemberg
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
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8
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Abstract
Infectious pericardial effusion with tamponade is an uncommon but life-threatening disease. We report an unusual case of spontaneous Ureaplasma pericardial effusion with tamponade associated with pneumonia, pleural effusion, and urinary tract infection. All published cases of clinically invasive Ureaplasma infections in the adult population are also reviewed.
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9
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Abstract
Few reports in the literature have documented the isolation of Ureaplasma species from sternal wounds. A case of sternal wound infection likely due to Ureaplasma parvum is described. When routine bacterial cultures from a sternal wound infection fail to yield a pathogen, diagnostic testing for mycoplasmas and ureaplasmas should be considered.
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10
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Méchaï F, Le Moal G, Duchêne S, Burucoa C, Godet C, Freslon M. Mycoplasma hominis osteitis in an immunocompetent man. Eur J Clin Microbiol Infect Dis 2007; 25:715-7. [PMID: 17033788 DOI: 10.1007/s10096-006-0209-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mycoplasma hominis has been associated with pelvic inflammatory illness, postpartum and neonatal infections and respiratory tract diseases. It is rarely isolated from patients with other infections. Reported here is a case of tibial osteitis that occurred in a 16-year-old immunocompetent man. Clinical and laboratory findings improved under treatment with clindamycin and fluoroquinolones.
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Affiliation(s)
- F Méchaï
- Department of Infectious Diseases, CHU de Poitiers, rue la milétrie, 86021, Poitiers cedex, France.
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Abstract
BACKGROUND The appearance of postoperative surgical site infection (SSI) in the absence of culturable bacterial pathogens is a common dilemma for the surgeon. METHODS The literature was searched through references to primary articles, as well as a MEDLINE review, for reports of culture-negative SSIs. RESULTS Potential causes of culture-negative SSIs include prior antimicrobial therapy; the presence of fastidious or slow-growing microorganisms such as mycobacteria, Mycoplasma spp., and Legionella spp.; infection caused by mundane bacteria that may be dismissed as "contaminants"; factitious infection; and others. CONCLUSIONS We review the recognized causes of "culture negative" SSIs and discuss the laboratory capabilities that may enhance recognition of many of these pathogens and management options.
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Affiliation(s)
- Mark S Rasnake
- Infectious Disease Services, Wilford Hall Air Force Medical Center, Lackland AFB, Texas, USA.
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Lapusan DL, Duffy L, Hamilos DL. Disseminated septic arthritis in a patient with common variable hypogammaglobulinemia. Ann Allergy Asthma Immunol 2001; 86:368-72. [PMID: 11345952 DOI: 10.1016/s1081-1206(10)62480-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D L Lapusan
- Washington University School of Medicine, Department of Allergy & Immunology, St Louis, Missouri, USA
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Legg JM, Titus TT, Chambers I, Wilkinson R, Koerner RJ, Gould FK. Hematoma infection with Mycoplasma hominis following transplant nephrectomy. Clin Microbiol Infect 2000; 6:619-21. [PMID: 11168067 DOI: 10.1046/j.1469-0691.2000.00147.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J M Legg
- Department of Microbiology, St Richards Hospital, Chichester, PO19 4SE, UK
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Mattila PS, Carlson P, Sivonen A, Savola J, Luosto R, Salo J, Valtonen M. Life-threatening Mycoplasma hominis mediastinitis. Clin Infect Dis 1999; 29:1529-37. [PMID: 10585808 DOI: 10.1086/313529] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Mycoplasma hominis infections are easily missed because conventional methods for bacterial detection may fail. Here, 8 cases of septic mediastinitis due to M. hominis are reported and reviewed in the context of previously reported cases of mediastinitis, sternum wound infection, pleuritis, or pericarditis caused by M. hominis. All 8 patients had a predisposing initial condition related to poor cardiorespiratory function, aspiration, or complications related to coronary artery surgery or other thoracic surgeries. Mediastinitis was associated with purulent pleural effusion and acute septic symptoms requiring inotropic medication and ventilatory support. Later, the patients had a tendency for indolent chronic courses with pleuritis, pericarditis, or open sternal wounds that lasted for several months. M. hominis infections may also present as mild sternum wound infection or as chronic local pericarditis or pleuritis without septic mediastinitis. Treatment includes surgical drainage and debridement. Antibiotics effective against M. hominis should be considered when treating mediastinitis of unknown etiology.
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Affiliation(s)
- P S Mattila
- Department of Otorhinolaryngology, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland.
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Zheng X, Olson DA, Tully JG, Watson HL, Cassell GH, Gustafson DR, Svien KA, Smith TF. Isolation of Mycoplasma hominis from a brain abscess. J Clin Microbiol 1997; 35:992-4. [PMID: 9157171 PMCID: PMC229719 DOI: 10.1128/jcm.35.4.992-994.1997] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Mycoplasma hominis is a commensal in the genital tract of women and has been associated with urogenital and extragenital infections. However, central nervous system infections with this organism in adults are very rare. Here we describe the recovery of M. hominis from a brain abscess associated with a postpartum infection. Seroconversion to the isolated strain was detected by both a metabolic inhibition test and an immunoblotting assay. This case demonstrates the pathogenic potential of M. hominis and the need for rapid recognition of the organism so that appropriate chemotherapeutic intervention can occur.
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Affiliation(s)
- X Zheng
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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