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Amoah KKA, Beach IR, Teague JM, Olszewski AM, DeWitt JC, Ducis KA. Campylobacter fetus seeding of a cavernous malformation resulting in brain abscess: case report and literature review. Childs Nerv Syst 2023; 39:3627-3631. [PMID: 37458769 DOI: 10.1007/s00381-023-06074-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/05/2023] [Indexed: 11/29/2023]
Abstract
Microbial seeding of a cerebral cavernous malformation is an extremely rare occurrence with only 3 cases reported in the literature thus far. Campylobacter fetus is an opportunistic pathogen that rarely causes neurological infection with only 3 cases of C. fetus cerebral abscesses and 38 cases of C. fetus meningitis reported in the literature. There have been no cases of cerebral cavernous malformation seeding by C. fetus reported to date. We report the first case of cerebral cavernous malformation seeding by C. fetus, a case occurring in a previously healthy 16-year-old female who presented with suspected left cerebellar cavernous malformation with subacute hemorrhage. She underwent a suboccipital craniectomy for the resection of the cavernous malformation with additional intraoperative findings suggestive of cerebral abscess. Following positive blood and CSF cultures and surgical pathology results, the patient was diagnosed with C. fetus meningoencephalitis with co-infected left cerebellar cavernous malformation. This is the fourth reported case of microbial seeding of a cerebral cavernous malformation, and to our knowledge, the first case of a C. fetus-infected cavernous malformation. Compared to previous reports, the clinical events of this case strongly support the presence of a preexisting lesion that was secondarily seeded versus de novo formation as a result of prior infection.
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Affiliation(s)
- Kali K A Amoah
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Isidora R Beach
- Larner College of Medicine, University of Vermont, Burlington, VT, USA.
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA.
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA.
| | - Joseph M Teague
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Adam M Olszewski
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - John C DeWitt
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Katrina A Ducis
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Neurosurgery, University of Vermont Medical Center, Burlington, VT, USA
- Department of Pathology & Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA
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Lynch CT, Buttimer C, Epping L, O'Connor J, Walsh N, McCarthy C, O'Brien D, Vaughan C, Semmler T, Bolton D, Coffey A, Lucey B. Phenotypic and genetic analyses of two Campylobacter fetus isolates from a patient with relapsed prosthetic valve endocarditis. Pathog Dis 2021; 79:6486444. [PMID: 34962980 DOI: 10.1093/femspd/ftab055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/24/2021] [Indexed: 11/12/2022] Open
Abstract
Campylobacter fetus can cause intestinal and systemic disease in humans and are well established veterinary and economic pathogens. We report the complete genomic sequences of two C. fetus subsp. fetus (Cff) isolates recovered in 2017 (CITCf01) and 2018 (CITCf02) from a case of recurrent prosthetic valve endocarditis. Both were capable of growth aerobically. Their genomes were found to be highly conserved and syntenic with 99.97% average nucleotide identity (ANI) while differences in their respective sap loci defined the temporal separation of their genomes. Based on core genome phylogeny and ANI of 83 Cff genomes belonging to the previously described human-associated Cff lineage, CITCf01 and CITCf02 grouped in a clade of eleven sequence type (ST)3 Cff (including the Cff type strain NCTC 10842T). CITCf01 and CITCf02 were marked for their lack of unique genomic features when compared to isolates within the subspecies and the type strain in particular. We identified point mutations in oxidative stress response genes, among others, that may contribute to aerobiosis. We report a case of Cff causing relapsed prosthetic valve endocarditis and we highlight the sap island as a polymorphic site within the genetically stable ST3 lineage, central to pathogenicity.
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Affiliation(s)
- Caoimhe T Lynch
- Department of Biological Sciences, Munster Technological University, Rossa Ave, Bishopstown, Cork, Ireland
| | - Colin Buttimer
- APC Microbiome Ireland, University College Cork, College Road, Cork, Ireland
| | - Lennard Epping
- Genome Sequencing and Genomic Epidemiology, Robert Koch Institute, Nordufer 20, Berlin, Germany
| | - James O'Connor
- Department of Microbiology, Grenville Place, Mercy University Hospital, Cork, Ireland
| | - Niamh Walsh
- Department of Biological Sciences, Munster Technological University, Rossa Ave, Bishopstown, Cork, Ireland
| | - Conor McCarthy
- Department of Biological Sciences, Munster Technological University, Rossa Ave, Bishopstown, Cork, Ireland
| | - Deirdre O'Brien
- Department of Microbiology, Grenville Place, Mercy University Hospital, Cork, Ireland
| | - Carl Vaughan
- Department of Cardiology, Grenville Place, Mercy University Hospital, Cork, Ireland
| | - Torsten Semmler
- Genome Sequencing and Genomic Epidemiology, Robert Koch Institute, Nordufer 20, Berlin, Germany
| | - Declan Bolton
- Food Safety Department, Teagasc Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland
| | - Aidan Coffey
- Department of Biological Sciences, Munster Technological University, Rossa Ave, Bishopstown, Cork, Ireland.,APC Microbiome Ireland, University College Cork, College Road, Cork, Ireland
| | - Brigid Lucey
- Department of Biological Sciences, Munster Technological University, Rossa Ave, Bishopstown, Cork, Ireland
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Amereller F, Lottspeich C, Buchholz G, Dichtl K. A horse and a zebra: an atypical clinical picture including Guillain-Barré syndrome, recurrent fever and mesenteric lymphadenopathy caused by two concomitant infections. Infection 2020; 48:471-475. [PMID: 32128685 PMCID: PMC7256024 DOI: 10.1007/s15010-020-01397-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/30/2020] [Indexed: 11/24/2022]
Abstract
Background While Campylobacter jejuni represents the most common cause of bacterial gastroenteritis, Yersinia pseudotuberculosis infections are very rarely diagnosed in adults. Case We report on a previously healthy patient who presented several times at our hospital with fever, Guillain-Barré syndrome, recurrent abdominal symptoms and distinct mesenteric lymphadenopathy, respectively. This complicated and diagnostically challenging course of disease was caused by a C. jejuni and Y. pseudotuberculosis coinfection. Antibiotic treatment with doxycycline was effective. Conclusion Broad serology testing was crucial to discover that two concomitant infections were causing the symptoms. This case demonstrates that when a clinical picture is not fully explained by one known infection, another infection with the same underlying risk factor has to be considered, hence “a horse and a zebra”. Electronic supplementary material The online version of this article (10.1007/s15010-020-01397-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Felix Amereller
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christian Lottspeich
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Grete Buchholz
- Department of Neurology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Karl Dichtl
- Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Fakultät, LMU München, Munich, Germany
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