1
|
Shimizu K, Horinishi Y, Sano C, Ohta R. Infection Route of Parvimonas micra: A Case Report and Systematic Review. Healthcare (Basel) 2022; 10:1727. [PMID: 36141340 PMCID: PMC9498800 DOI: 10.3390/healthcare10091727] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Parvimonas micra (P. micra), a bacterium that colonizes the gastrointestinal tract, is often isolated from periodontitis and abscesses as part of a complex bacterial infection. However, reports of monobacterium infections due to P. micra are limited. Here, we report a case of monobacterial bacteremia caused by P. micra with the aim of identifying the source of the invasion and clarifying the clinical features. A 54-year-old patient presented with bacteremia due to P. micra and with an oral invasion that we suspected resulted from prior dental treatment. Using PubMed and Google Scholar databases, we undertook a systematic review of monobacteremia caused by P. micra. We identified 26 patients (mean age, 70.15 years) in our systematic review. P. micra bacteremia and its associated phenotypes were most frequently identified in spinal discitis, followed by epidural and lumbar abscesses, and infective endocarditis. The major risk factors were malignancy, diabetes mellitus, and post-arthroplasty. When P. micra is detected in blood cultures, evaluation and intervention for oral contamination may be indicated.
Collapse
Affiliation(s)
- Kai Shimizu
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Yuta Horinishi
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| |
Collapse
|
2
|
Chen CT, Wu MH, Huang TY, Li YY, Huang TJ, Lee CY, Lin CH, Lee CY. Anaerobic spondylodiscitis: a retrospective analysis. BMC Musculoskelet Disord 2022; 23:788. [PMID: 35978349 PMCID: PMC9382781 DOI: 10.1186/s12891-022-05749-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background This retrospective study analyzed the clinical characteristics and outcomes of patients with anaerobic spondylodiscitis. Methods From a total of 382 patients with infectious spondylodiscitis, nine patients (2.4%; two male and seven female with an average age of 67 years) with anaerobic spondylodiscitis between March 2003 and March 2017 were analyzed. Results Most of the patients (77.8%) initially presented with afebrile back pain. Hematogenous spread occurred in seven patients and postoperative infection in two patients. Bacteroid fragilis was the most common pathogen isolated from three patients. Atypical radiographic characteristics, including a vertebral fracture with the preservation of disk height or coexisting spondylolytic spondylolisthesis, occurred in four patients with hematogenous anaerobic spondylodiscitis. The eradication rate of anaerobic infection was significantly higher in the patients with hematogenous infection than in those with postoperative infection (100% vs. 0%, p = 0.0476). Anaerobic spondylodiscitis accounted for 2.4% of cases of infectious spondylodiscitis and predominantly affected the female patients. Conclusions Diagnostic delay may occur because of atypical spinal radiographs if the patient reports only back pain but no fever. Anaerobic infection following elective spinal instrumentation has a higher recurrence rate.
Collapse
Affiliation(s)
- Chien-Ting Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Huang Wu
- Department of Orthopedics, Taipei Medical University Hospital, No.252, Wu-hsing St., Taipei, 11031, Taiwan.,Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, No.250, Wu-hsing St., Taipei, 11031, Taiwan
| | - Tsung-Yu Huang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yen-Yao Li
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tsung-Jen Huang
- Department of Orthopedics, Taipei Medical University Hospital, No.252, Wu-hsing St., Taipei, 11031, Taiwan.,Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, No.250, Wu-hsing St., Taipei, 11031, Taiwan
| | - Chien-Yin Lee
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Che-Han Lin
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ching-Yu Lee
- Department of Orthopedics, Taipei Medical University Hospital, No.252, Wu-hsing St., Taipei, 11031, Taiwan. .,Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, No.250, Wu-hsing St., Taipei, 11031, Taiwan. .,International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, No.250, Wu-hsing St., Taipei, 11031, Taiwan.
| |
Collapse
|
3
|
Neumann A. Rapid release of sepsis markers heparin-binding protein and calprotectin triggered by anaerobic cocci poses an underestimated threat. Anaerobe 2022; 75:102584. [DOI: 10.1016/j.anaerobe.2022.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022]
|
4
|
Native joint infections caused by Parvimonas micra. Anaerobe 2021; 71:102412. [PMID: 34217826 DOI: 10.1016/j.anaerobe.2021.102412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
Parvimonas micra is an anaerobic, fastidious, gram positive organism commonly found in the oral cavity and gastrointestinal tract. It has been increasingly reported as the cause of septic arthritis of native joints, often times with delayed diagnosis leading to increased morbidity. Risk factors include immunosuppression, inflammation of the joint, and recent dental procedures or infections. It has been a historically difficult organism to culture. However, the development of and increasing use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) has led to increased identification of P. micra. Common antibiotic susceptibilities, as well as data regarding susceptibilities in specific situations, have been reported, but susceptibility testing is required in all cases. Common treatments include clindamycin, penicillin, and metronidazole for six to ten weeks.
Collapse
|
5
|
Ryan PM, Morrey BF. Parvimonas micra causing native hip joint septic arthritis. Proc (Bayl Univ Med Cent) 2021; 34:486-488. [PMID: 34219932 DOI: 10.1080/08998280.2021.1906827] [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: 10/21/2022] Open
Abstract
Parvimonas micra is a bacterium normal to oral and gastrointestinal flora that has been implicated in cases of discitis, osteomyelitis, and prosthetic joint infections, often involving dental procedures or periodontal disease. It is an extremely rare cause of infection outside of these circumstances. We describe a case of septic arthritis of the native hip joint due to P. micra.
Collapse
Affiliation(s)
- Patrick M Ryan
- Department of Orthopedics, Baylor Scott and White Medical Center - Temple, Temple, Texas
| | - Bernard F Morrey
- Department of Orthopedics, UT Health San Antonio, San Antonio, Texas
| |
Collapse
|
6
|
Ali H, Amir W, Bolick NL. An uncommon case of native joint septic arthritis by Parvimonas micra. Anaerobe 2020; 67:102315. [PMID: 33348083 DOI: 10.1016/j.anaerobe.2020.102315] [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: 11/04/2020] [Revised: 12/06/2020] [Accepted: 12/13/2020] [Indexed: 12/29/2022]
Abstract
Parvimonas micra is an anaerobic, Gram-positive coccus found in the oral cavity and gastrointestinal tract. We report a case of a 77-year-old male with right knee pain after a recent dental procedure and fall. Arthrocentesis was notable for Parvimonas micra which was successfully treated with metronidazole.
Collapse
Affiliation(s)
- Hassam Ali
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA.
| | - Washma Amir
- Department of Internal Medicine, Dow Medical University, Karachi, Pakistan
| | - Nicole L Bolick
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA
| |
Collapse
|
7
|
Karampatakis T, Papavasiliou A, Dimitris Tatsis, Paraskevopoulos K, Katsifa H. A rare case of polymicrobial chronic maxillary sinusitis due to concurrent isolation of Parvimonas micra and Fusobacterium nucleatum. Anaerobe 2020; 66:102284. [DOI: 10.1016/j.anaerobe.2020.102284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022]
|
8
|
Abbas EE, Li C, Xie A, Lu S, Tang L, Liu Y, Elfadil A, Wen S. Distinct Clinical Pathology and Microbiota in Chronic Rhinosinusitis With Nasal Polyps Endotypes. Laryngoscope 2020; 131:E34-E44. [PMID: 32770821 DOI: 10.1002/lary.28858] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/12/2020] [Accepted: 05/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Eosinophilic and noneosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP and NECRSwNP) show distinguished clinical pathology, but their underlying mechanism remains unclear. We aimed to investigate the clinical, hematological, and histopathological changes in chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes and its association with microbiota. STUDY DESIGN A comparative cross-sectional study. METHODS A comparative study of 46 patients with CRSwNP (34.69 ± 16.39 years old) who underwent endoscopic sinus surgery were recruited and subdivided into ECRSwNP and NECRSwNP groups based on eosinophilic tissue inflammation; 12 healthy controls were also included. A structured histopathological analysis was conducted, and complete blood count was determined in patients. Endoscopic-guided middle meatus swabs and fecal samples were collected from the patients and controls and subsequently subjected to 16S rRNA gene sequencing on Illumina MiSeq. RESULTS Compared to NECRSwNP, ECRSwNP showed a statistically significant increase in the computed tomography score, endoscopic score, blood eosinophil percentage, tissue eosinophil count, inflammation degree, subepithelial edema, and eosinophil aggregation. Airway microbiota communities differed among the three groups. The abundance of Moraxella and Parvimonas was significantly higher in the ECRSwNP group. Distinct microbiota dysbiosis in CRSwNP endotypes was found to be correlated with different clinical pathologies. Moreover, the gut microbiota in ECRSwNP and NECRSwNP showed dysbiosis, that is, significant decrease in the abundance of Actinobacteria in the former and significant increase in the abundance of Enterobacterales and several genera in NECRSwNP. CONCLUSIONS Significant clinical pathology and microbiota changes were evident in patients with ECRSwNP and NECRSwNP. Distinct microbiota dysbiosis was correlated with different clinical pathologies. Understanding these differences may improve the prognosis and treatment of chronic rhinosinusitis. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E34-E44, 2021.
Collapse
Affiliation(s)
- Elrayah E Abbas
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China.,Department of Microbiology, Military Hospital, Khartoum, Sudan
| | - Chuan Li
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Ao Xie
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Shan Lu
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Li Tang
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Yinhui Liu
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Ayman Elfadil
- Department of Otolaryngology, Military Hospital, Khartoum, Sudan
| | - Shu Wen
- Department of Microecology, Collage of Basic Medical Science, Dalian Medical University, Dalian, China
| |
Collapse
|
9
|
Watanabe T, Hara Y, Yoshimi Y, Fujita Y, Yokoe M, Noguchi Y. Clinical characteristics of bloodstream infection by Parvimonas micra: retrospective case series and literature review. BMC Infect Dis 2020; 20:578. [PMID: 32758181 PMCID: PMC7405351 DOI: 10.1186/s12879-020-05305-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Background Gram-positive anaerobic (GPA) bacteria inhabit different parts of the human body as commensals but can also cause bacteremia. In this retrospective observational study, we analyzed GPA bacteremia pathogens before (2013–2015) and after (2016–2018) the introduction of the matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). Method We conducted a retrospective observational study by searching the microbiology database to identify all positive GPA blood cultures of patients with GPA bacteremia diagnosed using the new technique, MALDI-TOF MS, between January 1, 2016 and December 31, 2018; and using a conventional phenotypic method between January 1, 2013 and December 31, 2015 at a single tertiary center in Japan. Parvimonas micra (P. micra) (17.5%) was the second most frequently identified GPA (MALDI-TOF MS); we then retrospectively reviewed electronic medical records for 25 P. micra bacteremia cases at our hospital. We also conducted a literature review of published cases in PubMed from January 1, 1980, until December 31, 2019; 27 cases were retrieved. Results Most cases of P. micra bacteremia were identified after 2015, both, at our institute and from the literature review. They were of mostly elderly patients and had comorbid conditions (malignancies and diabetes). In our cases, laryngeal pharynx (7/25, 28%) and gastrointestinal tract (GIT; 6/25, 24%) were identified as the most likely sources of bacteremia; however, the infection source was not identified in 9 cases (36%). P. micra bacteremia were frequently associated with spondylodiscitis (29.6%), oropharyngeal infection (25.9%), intra-abdominal abscess (14.8%), infective endocarditis (11.1%), septic pulmonary emboli (11.1%), and GIT infection (11.1%) in the literature review. Almost all cases were treated successfully with antibiotics and by abscess drainage. The 30-day mortalities were 4 and 3.7% for our cases and the literature cases, respectively. Conclusions Infection sites of P. micra are predominantly associated with GIT, oropharyngeal, vertebral spine, intra-abdominal region, pulmonary, and heart valves. Patients with P. micra bacteremia could have good prognosis following appropriate treatment.
Collapse
Affiliation(s)
- Tsuyoshi Watanabe
- Department of Rheumatology, Chubu Rosai Hospital, 2-10-15, Komei-cho, Minato-ku, Nagoya, Aichi, 455-8530, Japan.
| | - Yuki Hara
- Department of Clinical Laboratory, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, 466-8650, Japan
| | - Yusuke Yoshimi
- Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, 466-8650, Japan
| | - Yoshiro Fujita
- Department of Rheumatology, Chubu Rosai Hospital, 2-10-15, Komei-cho, Minato-ku, Nagoya, Aichi, 455-8530, Japan
| | - Masamichi Yokoe
- Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, 466-8650, Japan
| | - Yoshinori Noguchi
- Department of General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, 466-8650, Japan
| |
Collapse
|
10
|
Miyazaki M, Asaka T, Takemoto M, Nakano T. Severe sepsis caused by Parvimonas micra identified using 16S ribosomal RNA gene sequencing following patient death. IDCases 2019; 19:e00687. [PMID: 32071875 PMCID: PMC7011025 DOI: 10.1016/j.idcr.2019.e00687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 01/06/2023] Open
Abstract
An 83-year-old man visited an orthopedic hospital for his lower back pain. A compression fracture was noted in his second lumbar vertebra. He had taken pain medication for approximately five weeks, but the pain had worsened and he was unable to walk by himself. He was transferred to our hospital and diagnosed with lumbar spondylodiscitis, an iliopsoas abscess, gas gangrene of his left lower limb, and left massive pleural effusion. He was admitted to the intensive care unit. We drained the abscess and pleural effusion, provided continuous hemodiafiltration under ventilator control, and administered intravenous antibiotics. However, he died from sepsis and multiple organ failure three days following admission. Several days after his death, gram-positive cocci were identified in blood culture, pus from the abscess, and pleural exudate; although the causative organism could not be identified. Two weeks subsequent to his death, 16S ribosomal RNA gene sequencing identified Parvimonas micra in specimens taken from his body.
Collapse
Affiliation(s)
- Manami Miyazaki
- Department of Emergency Medicine, Yokohama Sakae Kyousai Hospital, 132 Katsura Sakae-ku, Yokohama, Kanagawa, 247-8581 Japan
| | - Tomoya Asaka
- Department of Emergency Medicine, Yokohama Sakae Kyousai Hospital, 132 Katsura Sakae-ku, Yokohama, Kanagawa, 247-8581 Japan
| | - Masaaki Takemoto
- Department of Emergency Medicine, Yokohama Sakae Kyousai Hospital, 132 Katsura Sakae-ku, Yokohama, Kanagawa, 247-8581 Japan
| | - Takaaki Nakano
- Department of Emergency Medicine, Shin Yurigaoka General Hospital, 255 Furusawatuko Asou-ku, Kawasaki, Kanagawa, 247-8581 Japan
| |
Collapse
|
11
|
Yoo LJH, Zulkifli MD, O'Connor M, Waldron R. Parvimonas micra spondylodiscitis with psoas abscess. BMJ Case Rep 2019; 12:12/11/e232040. [PMID: 31748364 DOI: 10.1136/bcr-2019-232040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Parvimonas micra (P. micra) is a Gram-positive anaerobic cocci, normally found in the oral cavity and rarely causes severe infections. We describe a rare clinical presentation of P. micra as spondylodiscitis and psoas abscess with haematogenous spread in an adult patient. MRI lumbar spine detected L2 and L3 spondylodiscitis. Blood cultures were positive at 48 hours of incubation and P. micra was identified on anaerobic culture after 72 hours. Isolates from bone biopsy confirms P. micra She was successfully treated with ceftriaxone, followed by oral metronidzole for a total of 8 weeks. The suspected origin of her P. micra was a dental cavity. Anaerobic bacteria tend to be underestimated in spondylodiscitis. In cases of slow growing organisms, we emphasise the importance of performing accurate identification including anaerobic bacteria to guide management. P. micra should be considered in patients with spondylodiscitis who had recent dental intervention or perioral infection.
Collapse
Affiliation(s)
- Li Jie Helena Yoo
- Department of Internal Medicine, University Hospital Limerick, Limerick, Ireland
| | | | - Margaret O'Connor
- Department of Therapeutics and Ageing, University Hospital Limerick, Limerick, Ireland
| | - Ruth Waldron
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| |
Collapse
|
12
|
Thiery A, Anagnostakos K. [Periprosthetic hip-TEP infections after dental procedures : Maybe an indication for antibiotic treatment after all?]. DER ORTHOPADE 2019; 47:590-593. [PMID: 29691603 DOI: 10.1007/s00132-018-3572-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Periprosthetic infections are hazardous complications. After dental procedures, an antibiotic prophylaxis or treatment is actually not recommended according to the current guidelines. In the present work, a case of a hematogenous late infection after primary total hip arthroplasty due to a prior dental procedure is presented. Hereby, the question evolves as to whether in selected cases an antibiotic prophylaxis or treatment might be indicated at the site of dental procedures.
Collapse
Affiliation(s)
- Andreas Thiery
- Zentrum für Orthopädie und Unfallchirurgie, Städtisches Klinikum Saarbrücken, Winterberg 1, 66119, Saarbrücken, Deutschland.
| | - Konstantinos Anagnostakos
- Zentrum für Orthopädie und Unfallchirurgie, Städtisches Klinikum Saarbrücken, Winterberg 1, 66119, Saarbrücken, Deutschland
| |
Collapse
|
13
|
van Duijvenbode DC, Kuiper JWP, Holewijn RM, Stadhouder A. Parvimonas micra Spondylodiscitis: A Case Report and Systematic Review of the Literature. J Orthop Case Rep 2019; 8:67-71. [PMID: 30740380 PMCID: PMC6367290 DOI: 10.13107/jocr.2250-0685.1216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Treatment and risk factors for Parvimonas micra spinal infections are scarcely researched. This study reports a case and presents a systematic review of the literature to provide evidence-based ground for diagnosis and treatment of P. micra spinal infections. Case Report This is a case of a 78-year-old male with severe back and leg pain. Advanced imaging demonstrated the destruction of L2-L3 with an extensive fluid collection in the remaining intervertebral space, paravertebral myositis, and multiple abscesses. A decompression of L2 and L3 and a posterior spondylodesis from T12 to L5 was performed. Intraoperative cultures showed P. micra. The postoperative treatment consisted of intravenous penicillin for 2 weeks and subsequent oral clindamycin for 4 weeks. At 1-year follow-up, the patient was in good health and reported only occasional back pain. Conclusions A total of 15 additional cases of P. micraspinal infections were identified. The antibiotic treatment showed a great variety in the treated patients. Nevertheless, the outcome of these patients was good concerning relapse of the infection and pain. Spinal infections caused by P. micra are rare, but can be successfully treated according to the guidelines for spinal infection.
Collapse
Affiliation(s)
- D C van Duijvenbode
- Department of Orthopaedic Surgery, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - J W P Kuiper
- Department of Orthopaedic Surgery, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - R M Holewijn
- Department of Orthopaedic Surgery, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - A Stadhouder
- Department of Orthopaedic Surgery, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
14
|
Parvimonas micra bacteremia following endoscopic retrograde cholangiopancreatography: A new route of infection. Anaerobe 2018; 54:136-139. [PMID: 30217496 DOI: 10.1016/j.anaerobe.2018.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/03/2018] [Accepted: 09/10/2018] [Indexed: 12/20/2022]
Abstract
Parvimonas micra is an anaerobic, Gram-positive coccus belonging to oral, gastrointestinal and genital flora, rarely causing infections in humans. It was mainly deemed to cause bacteremia, septic bone and cerebral infections in patients which have undergone dental procedures or with suboptimal dental hygiene. We report the first case of Parvimonas micra bacteremia following endoscopic retrograde colangiopancreatography performed due to choledocholithiasis in a patient with good oral health. Identification of P. micra was finally performed by Matrix-assisted laser desorption ionization-time of flight mass spectrometry (VITEK MS system, bioMérieux, Marcy l'Étoile, France). All cases reported in english language of Parvimonas micra infections after medical procedure are reviewed in order to alert clinicians about new possible routes of infection of this emerging pathogen.
Collapse
|
15
|
Roy M, Roy AK, Ahmad S. Septic arthritis of knee joint due to Parvimonas micra. BMJ Case Rep 2017; 2017:bcr-2017-221926. [PMID: 29141929 DOI: 10.1136/bcr-2017-221926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Parvimonas species are anaerobic, Gram-positive cocci that are a constituent of normal oral and gastrointestinal flora. We present a case of right knee joint septic arthritis due to Parvimonas micra in an immunocompromised patient. A 61-year-old male renal and pancreatic transplant recipient on immunosuppressive therapy was admitted to our hospital due to intense pain, joint swelling and inability to move his right knee over the past 9 months. After synovial fluid was drawn, cultures were positive for P. micra, an anaerobic pathogen that is part of the flora of the oral cavity. We report a rare causative pathogen for septic arthritis in an immunocompromised patient.
Collapse
Affiliation(s)
- Moni Roy
- Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Ashish Kumar Roy
- Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Sharjeel Ahmad
- Internal Medicine, Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
| |
Collapse
|
16
|
Higashi Y, Nakamura S, Niimi H, Ueno T, Matsumoto K, Kawago K, Sakamaki I, Kitajima I, Yamamoto Y. Spondylodiscitis due to Parvimonas micra diagnosed by the melting temperature mapping method: a case report. BMC Infect Dis 2017; 17:584. [PMID: 28835212 PMCID: PMC5569488 DOI: 10.1186/s12879-017-2690-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023] Open
Abstract
Background It has been suggested that more than 100 bacterial species can be identified using only seven universal bacterial primer sets in the melting temperature (Tm) mapping method and that these findings can be obtained within 3 h of sterile site collection. Case presentation A 67-year-old Japanese man with type 2 diabetes visited our hospital complaining of progressive lower back pain for 2 months. The patient was suspected to have spondylodiscitis on magnetic resonance imaging of the spine. Blood culture and transcutaneous vertebral biopsy were subsequently performed. Using the Tm mapping method, Parvimonas micra was detected from a transcutaneous vertebral biopsy specimen in 3 h. Gram-positive cocci were also detected by Gram staining and P. micra was identified directly from the anaerobic blood culture by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Four days after admission, the biopsy specimen culture isolate was identified as P. micra. Conclusions The Tm mapping method may be useful for the diagnosis of bacterial infections where diagnosis is challenging because of the difficulty of culturing.
Collapse
Affiliation(s)
- Yoshitsugu Higashi
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institutes of Infectious Diseases, Tokyo, Japan
| | - Hideki Niimi
- Department of Laboratory Medicine, Toyama University Hospital, Toyama, Japan
| | - Tomohiro Ueno
- Department of Laboratory Medicine, Toyama University Hospital, Toyama, Japan
| | - Kaoru Matsumoto
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Koyomi Kawago
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Ippei Sakamaki
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Isao Kitajima
- Department of Laboratory Medicine, Toyama University Hospital, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
| |
Collapse
|
17
|
Shtaya A, Schuster H, Riley P, Harris K, Hettige S. Oesophageal pleural fistula presenting with Parvimonas micra infection causing cervical and brain abscesses. Anaerobe 2017. [PMID: 28648472 DOI: 10.1016/j.anaerobe.2017.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parvimonas micra (P. micra) infections causing spinal cord compression are extremely rare. We report an occult oesophageal pleural fistula presenting with spinal epidural and brain abscesses resulting in severe neurological deficits caused by P. micra. Molecular detection proved to be instrumental in identifying the causative pathogen. Essential management with decompression, drainage, antibiotics and fistula repair lead to a good outcome.
Collapse
Affiliation(s)
- Anan Shtaya
- Academic Neurosurgery Unit, St George's University of London, London, UK.
| | - Helmut Schuster
- Department of Microbiology, University Hospitals Southampton, Southampton, UK
| | - Peter Riley
- Department of Microbiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kathryn Harris
- Department of Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Samantha Hettige
- Academic Neurosurgery Unit, St George's University of London, London, UK
| |
Collapse
|
18
|
Cleaver LM, Palanivel S, Mack D, Warren S. A case of polymicrobial anaerobic spondylodiscitis due to Parvimonas micra and Fusobacterium nucleatum. JMM Case Rep 2017; 4:e005092. [PMID: 29026618 PMCID: PMC5630959 DOI: 10.1099/jmmcr.0.005092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/29/2017] [Indexed: 12/28/2022] Open
Abstract
Introduction. Here, we present a case of polymicrobial anaerobic spondylodiscitis. Case Presentation. A forty-five year-old female patient was referred to a specialist orthopaedic hospital with an eight week history of back pain without fevers. X-ray imaging and magnetic resonance imaging showed acute osteomyelitis of the twelfth thoracic and first lumbar vertebrae. Prolonged enrichment cultures grew Parvimonas micra and Fusobacterium nucleatum, identified by matrix-assisted laser desorption ionisation-time of flight (MALDI-ToF) mass spectrometry (MS). The patient was successfully treated with six weeks of intravenous ertapenem and oral clindamycin. Conclusion. Anaerobic discitis is rare, and polymicrobial discitis is rarer still. A PubMed literature review revealed only seven cases of F. nucleatum discitis and only twelve cases of P. micra discitis; this includes only one other reported case of a polymicrobial discitis due to infection with both anaerobes. We emphasise the importance of prolonging enrichment culture and the use of fast yet accurate identification of anaerobes using MALDI-ToF MS in these infections.
Collapse
Affiliation(s)
| | - Shara Palanivel
- Royal Free London NHS Foundation Trust, London, UK
- Royal National Orthopaedic Hospital, Stanmore, London, UK
| | - Damien Mack
- Royal Free London NHS Foundation Trust, London, UK
- Royal National Orthopaedic Hospital, Stanmore, London, UK
| | - Simon Warren
- Royal Free London NHS Foundation Trust, London, UK
- Royal National Orthopaedic Hospital, Stanmore, London, UK
| |
Collapse
|
19
|
Dietvorst M, Roerdink R, Leenders ACAP, Kiel MA, Bom LPA. Acute Mono-Arthritis of the Knee: A Case Report of Infection with Parvimonas Micra and Concomitant Pseudogout. J Bone Jt Infect 2016; 1:65-67. [PMID: 28529856 PMCID: PMC5423566 DOI: 10.7150/jbji.16124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Parvimonas micra is a rare pathogen for septic arthritis and is known for its subacute onset. We report a case of acute arthritis of the knee caused by P. micra and pseudogout. Initially, calcium pyrophosphate crystals were found in the knee, which were successfully treated with a steroid injection. Only anaerobic cultures became positive. A 16S rRNA PCR-analysis was necessary to identify P. micra as causative agent, a method which is never described before in similar cases. The infection was treated with clindamycin for 6 weeks. This is the third case report of a septic arthritis caused by P. micra and the second which also reports concomitant pseudogout.
Collapse
Affiliation(s)
| | - Ramon Roerdink
- Jeroen Bosch general hospital, 's-Hertogenbosch, The Netherlands
| | | | - Menno A Kiel
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L Paul A Bom
- Jeroen Bosch general hospital, 's-Hertogenbosch, The Netherlands
| |
Collapse
|
20
|
Baghban A, Gupta S. Parvimonas micra: A rare cause of native joint septic arthritis. Anaerobe 2016; 39:26-7. [PMID: 26911898 DOI: 10.1016/j.anaerobe.2016.02.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 02/13/2016] [Indexed: 11/30/2022]
Abstract
Parvimonas micra is a fastidious, anaerobic, gram positive coccus, which is found in normal human oral and gastrointestinal flora. It has also been known as Peptostreptococcus micros and Micromonas micros with its most recent re-classification in 2006. It has been described in association with hematogenous seeding of prosthetic joints [1,2]. Several cases of discitis and osteomyelitis have been described in association with dental procedures and periodontal disease often with a subacute presentation. However, cases of native joint septic arthritis are limited [3-5]. Per our literature review, there is one case of native knee septic arthritis described in 1999, with a prolonged time to diagnosis and treatment due to difficulty culturing P. micra. The previously reported patient experienced significant joint destruction and morbidity [6]. Advances in culture techniques and new methods of organism identification including MALDI-TOF and 16s rRNA sequencing have lead to increased identification of this organism, which may be a more frequent bone and joint pathogen than previously realized.
Collapse
Affiliation(s)
- Adam Baghban
- Yale University School of Medicine, United States.
| | - Shaili Gupta
- Yale University School of Medicine, United States
| |
Collapse
|
21
|
Gomez CA, Gerber DA, Zambrano E, Banaei N, Deresinski S, Blackburn BG. First case of infectious endocarditis caused by Parvimonas micra. Anaerobe 2015; 36:53-5. [PMID: 26485192 DOI: 10.1016/j.anaerobe.2015.10.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/12/2015] [Accepted: 10/14/2015] [Indexed: 12/16/2022]
Abstract
P. micra is an anaerobic Gram-positive cocci, and a known commensal organism of the human oral cavity and gastrointestinal tract. Although it has been classically described in association with endodontic disease and peritonsillar infection, recent reports have highlighted the role of P. micra as the primary pathogen in the setting of invasive infections. In its most recent taxonomic classification, P. micra has never been reported causing infectious endocarditis in humans. Here, we describe a 71 year-old man who developed severe native valve endocarditis complicated by aortic valvular destruction and perivalvular abscess, requiring emergent surgical intervention. Molecular sequencing enabled identification of P. micra.
Collapse
Affiliation(s)
- Carlos A Gomez
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Lane Building L 134, Stanford, CA 94305, USA.
| | - Daniel A Gerber
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Lane Building L 134, Stanford, CA 94305, USA
| | - Eduardo Zambrano
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305, USA
| | - Niaz Banaei
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305, USA; Clinical Microbiology Laboratory, Stanford Hospital and Clinics, 3375 Hillview Ave, Palo Alto, CA 94304, USA
| | - Stan Deresinski
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Lane Building L 134, Stanford, CA 94305, USA
| | - Brian G Blackburn
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Lane Building L 134, Stanford, CA 94305, USA
| |
Collapse
|