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Jiang ZJ, Hong JC, Tang QX, Lin BW, Zhang WQ, Xia H, Yao XP. Streptococcus suis meningoencephalitis diagnosed with metagenomic next-generation sequencing: A case report with literature review. J Infect Chemother 2024; 30:544-547. [PMID: 37992864 DOI: 10.1016/j.jiac.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Streptococcus suis is a pathogen of emerging zoonotic diseases and meningoencephalitis is the most frequent clinical symptom of S. suis infection in humans. Rapid diagnosis of S. suis meningoencephalitis is critical for the treatment of the disease. While the current routine microbiological tests including bacterial culture and gram staining are poorly sensitive, diagnosis of S. suis meningoencephalitis by metagenomic next-generation sequencing (mNGS) has been rarely reported. Here, we report a 52-year-old female pork food producer with a broken finger developed S. suis meningoencephalitis. After her admission, no pathogenic bacteria were detected through bacterial culture and Gram staining microscopy in the cerebrospinal fluid obtained via lumbar puncture. However, mNGS identified the presence of S. suis in the sample. mNGS is a promising diagnostic tool for rapid diagnosis of rare infectious diseases in the central nervous system.
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Affiliation(s)
- Zai-Jie Jiang
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China
| | - Jian-Chen Hong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China
| | - Qing-Xi Tang
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China
| | - Bi-Wei Lin
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China
| | - Wei-Qing Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China
| | - Han Xia
- Hugobiotech Co., Ltd, Beijing, China
| | - Xiang-Ping Yao
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
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Syrogiannopoulos GA, Michoula AN, Syrogiannopoulou TG, Anthracopoulos MB. S treptococcus intermedius and Other Streptococcus anginosus Group Species in Pediatric Cranial and Intracranial Pyogenic Infections. Pediatr Infect Dis J 2024; 43:e92-e95. [PMID: 38011035 DOI: 10.1097/inf.0000000000004182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
| | - Aspasia N Michoula
- From the Department of Pediatrics, School of Medicine, University of Thessaly, Larissa, Greece
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Yang HH, Li M, Yu Q, Liu Q, Liu M. Empyema caused by Streptococcus constellatus in a patient infected with HIV: a case report and literature review. AIDS Res Ther 2024; 21:2. [PMID: 38173032 PMCID: PMC10765925 DOI: 10.1186/s12981-023-00587-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Empyema caused by Streptococcus constellatus (S. constellatus) is rare in patients with HIV. To analyze the clinical data of a patient living with HIV (PLHIV), who got empyema caused by S. constellatus, investigating the diagnosis and treatment of this disease through literature review to improve the clinical understanding of this disease. CASE PRESENTATION We have reported here a 58-year-old male PLHIV with cough, wheezing, and fever for 20 days. He has a history type 2 diabetes, alcohol abuse, and a teeth extracted. Chest computed tomography revealed multiple encapsulated pleural effusions, pneumatosis, and partial compressive atelectasis in the right lung. Submission of pleural efusions timely, and then cultures revealed S. constellatus. After comprehensive treatment, including antibiotics, closed pleural drainage, and intrapleural injection of urokinase, the pleural efusion was absorbed, and chest computed tomography also confirmed the improvement. CONCLUSIONS S. constellatus should not be neglected as a pus pathogen in patients with HIV. comprehensive treatment is important for empyema of S. constellatus.
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Affiliation(s)
- Hong-Hong Yang
- Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China
| | - Mei Li
- Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China
| | - Qing Yu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China
| | - Qian Liu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China
| | - Min Liu
- Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China.
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Duan Y, Feng W, Shen Y, Li Y, Li N, Chen X, Wang Y. Severe pneumonia with empyema caused by Parvimonas micra and Streptococcus constellatus co-infection: a case report. J Int Med Res 2023; 51:3000605231210657. [PMID: 37994021 PMCID: PMC10666820 DOI: 10.1177/03000605231210657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/12/2023] [Indexed: 11/24/2023] Open
Abstract
Empyema is a common complication of pneumonia, caused by the accumulation of purulent exudate due to pathogenic bacteria invading the pleural cavity. Parvimonas micra and Streptococcus constellatus are pathogens that rarely cause pneumonia with empyema. Herein, a case of severe empyema caused by these two pathogens, confirmed by metagenomic next-generation sequencing (mNGS) of pleural effusion cultures, is reported. A male Chinese patient in his late sixties presented with wheezing, cough, sputum expectoration, and fever. Blood and sputum cultures were negative for pathogens, but the pleural effusion culture was positive for S. constellatus, and was also found to contain P. micra, confirmed by mNGS. The patient's symptoms improved after treatment with cefoperazone/sulbactam and moxifloxacin. Pneumonia caused by P. micra and S. constellatus is rare; however, coinfection with these pathogens may cause severe pneumonia, with or without empyema.
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Affiliation(s)
- Yao Duan
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wenshi Feng
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yuxin Shen
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yue Li
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ni Li
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xuyan Chen
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yiqun Wang
- General Internal Medicine Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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Chen L, Nie Z, Zhao Y, Bao B. Peritonitis-associated with peritoneal dialysis following Ureaplasma parvum infection: A case report and literature review. Indian J Med Microbiol 2023; 45:100410. [PMID: 37573047 DOI: 10.1016/j.ijmmb.2023.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/09/2023] [Accepted: 06/07/2023] [Indexed: 08/14/2023]
Abstract
We report a patient diagnosed with peritonitis due to a rare infection of Ureaplasma parvum after receiving peritoneal dialysis for two years. This microorganism rarely causes peritoneal dialysis-associated peritonitis (PDAP). This is the first case of PDAP caused by Ureaplasma parvum. In the present case, the pathogen was identified through next-generation sequencing of PD fluid samples. The patient was treated with intraperitoneal (IP) levofloxacin combined with vancomycin and oral clarithromycin which effectively improved her symptoms. This case creates awareness that Ureaplasma parvum can cause PDAP and can be diagnosed using next-generation sequencing(NGS).
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Affiliation(s)
- Luyan Chen
- Health Science center, Ningbo University, Ningbo, China.
| | - Zhenyu Nie
- Department of Nephrology, Ningbo Yinzhou No.2 Hospital (Ningbo Urology and Nephrology Hospital), Ningbo, China.
| | - Yu Zhao
- Department of Nephrology, Ningbo Yinzhou No.2 Hospital (Ningbo Urology and Nephrology Hospital), Ningbo, China.
| | - Beiyan Bao
- Department of Nephrology, Ningbo Yinzhou No.2 Hospital (Ningbo Urology and Nephrology Hospital), Ningbo, China.
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Sun Y, Dong H, Zhang N, Zhao P, Qi Y, Yang X, Wang L. Empyema caused by Fusobacterium nucleatum with squamous cell carcinoma of the lung: a case report and literature review. Front Med (Lausanne) 2023; 10:1099040. [PMID: 37305143 PMCID: PMC10248407 DOI: 10.3389/fmed.2023.1099040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background Fusobacterium nucleatum is a common oral symbiotic flora that can cause respiratory tract, oral nervous system, obstetric and skin infections. Fusobacterium nucleatum infections are mostly caused by aspiration. The clinical manifestations of pulmonary infections with Fusobacterium nucleatum can include simple pneumonia, lung abscesses, empyema, etc. Case presentation We described the case of a 49-year-old man with a 1-year history of intermittent cough and sputum production who had worsened over the last 4 days with fever and right chest pain. After thoracentesis and catheter drainage were performed, Fusobacterium nucleatum was detected in the pleural effusion by using next-generation sequencing. Meanwhile, a diagnosis of squamous cell carcinoma of the right lung was made by fiberoptic bronchoscopy. The patient's condition improved significantly after percutaneous drainage and long-term intravenous antibiotic treatment. Conclusions This is the first case reported of empyema due to Fusobacterium nucleatum infection in a patient with squamous cell carcinoma.
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Zhang W, Lai Y, Li T, Wang X, Mu W, Jiang Z. Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus constellatus Leads to Paraplegia in an Adult: A Case Report. Infect Drug Resist 2023; 16:1591-1598. [PMID: 36969946 PMCID: PMC10032216 DOI: 10.2147/idr.s405448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/11/2023] [Indexed: 03/20/2023] Open
Abstract
The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.
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Affiliation(s)
- Wen Zhang
- Department of Spine Surgery, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
- Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Yudong Lai
- Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Tao Li
- Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Xingpeng Wang
- Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Weidong Mu
- Department of Traumatic Orthopaedics, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China
- Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Zhensong Jiang
- Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
- Correspondence: Zhensong Jiang; Weidong Mu, Email ;
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Deng Z, Zhu H, Du W, Zhang H. Abdominal infection combined with pneumoperitoneum after renal transplantation: A case report. Medicine (Baltimore) 2023; 102:e32836. [PMID: 36749270 PMCID: PMC9901997 DOI: 10.1097/md.0000000000032836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Abdominal infection combined with pneumoperitoneum after renal transplantation is rare, clinically confusing, and easily misdiagnosed by physicians as gastrointestinal perforation. PATIENT CONCERNS A 54-year-old man experienced abdominal pain and distension together with signs of peritoneal irritation after cadaveric renal transplantation. CT and standing abdominal plain film showed a large pneumoperitoneum in the abdominal cavity and the patient underwent an exploratory laparotomy but no gastrointestinal perforation was found. DIAGNOSIS No gastrointestinal perforation was found during the operation. In the search for the infectious agent, ascites culture was negative while next-generation sequencing was positive, suggesting the presence of intestinal flora ectopic to abdominal infection with anaerobic respiration fermentation leading to large amounts of gas. INTERVENTIONS The patient underwent exploratory laparotomy without gastrointestinal perforation, and then underwent abdominal lavage, placed abdominal drainage tube, and conducted culture and next-generation sequencing examination of ascites. OUTCOMES Postoperative symptoms were relieved and intestinal function recovered. After 3 months of outpatient follow-up, the patient had stable transplanted kidney function and was in good spirits and sleeping well, with a good appetite, soft and regular stools, no abdominal pain and distension, and no fever. CONCLUSION Patients after kidney transplantation should be wary of abdominal infection being misdiagnosed as gastrointestinal perforation.
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Affiliation(s)
- Zhiming Deng
- Organ Transplantation Department, The First People’s Hospital of Changde City, Changde, China
| | - Huachen Zhu
- Organ Transplantation Department, The First People’s Hospital of Changde City, Changde, China
| | - Wei Du
- Organ Transplantation Department, The First People’s Hospital of Changde City, Changde, China
| | - Hongwei Zhang
- Organ Transplantation Department, The First People’s Hospital of Changde City, Changde, China
- *Correspondence: Hongwei Zhang, Organ Transplantation Department, The First People’s Hospital of Changde City, # 818 Renmin Middle Road, Changde, Hunan 415003, China (e-mail: )
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Badar F, Ashraf A, Usman S, Iftikhar A. Septic shock from multiple intra-abdominal Streptococcus constellatus abscesses unamenable to percutaneous drainage. Arch Clin Cases 2022; 9:117-120. [PMID: 36176498 PMCID: PMC9512127 DOI: 10.22551/2022.36.0903.10215] [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] [Indexed: 11/25/2022] Open
Abstract
Streptococcus constellatus are gram-positive cocci belonging to the Streptococcus milleri group that have a propensity to cause bacteremia and abscesses, especially in immunocompromised patients. Here, we report the case of a 39-year-old male who was initially admitted to the hospital for diabetic ketoacidosis. During the hospitalization, he developed sepsis and blood cultures grew Streptococcus constellatus. CT imaging revealed multiple hepatic abscesses. A periapical abscess of the left mandibular central incisor found on CT Scan of face was identified as the likely source of infection. IR-guided drainage was performed however the patient went on to develop septic shock despite attempted source control and IV antibiotic therapy. Repeat imaging showed persistent hepatic abscesses in addition to new intraperitoneal abscesses necessitating exploratory laparotomy, drainage and abdominal washout. Fluid cultures grew Streptococcus constellatus and common enteric flora. Our report highlights the need for high clinical suspicion in cases of Streptococcus constellatus bacteremia to obtain diagnostic imaging for any abscess formation. Prolonged antibiotic therapy is a must and imaging guided or surgical drainage may be needed.
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Affiliation(s)
| | | | | | - Asma Iftikhar
- Corresponding author: Asma Iftikhar, Department of Pulmonary and Critical Care, Zucker School of Medicine at Hofstra/Northwell - Mather Hospital, 125 Community Dr. Great Neck, NY 11021 USA.
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Jin Y, Yin X. Acute Pyogenic Spondylitis Caused by Streptococcus Constellatus in an Obese Patient: A Case Report. Infect Drug Resist 2022; 15:4361-4367. [PMID: 35971556 PMCID: PMC9375553 DOI: 10.2147/idr.s371411] [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] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Streptococcus constellatus (S. constellatus) is a well-known part of the normal flora in humans. Pyogenic spondylitis (PS) induced by S. constellatus is very rare. In this case, a 46-year-old male patient presented to our hospital with a 2-month history of low back pain and weakness in both legs. Based on his clinical manifestations, laboratory findings, blood culture results, imaging and histopathological findings, the patient was diagnosed with PS caused by S. constellatus. One unique aspect of this case is the acute and severe course of infection, which resulted in multiple organ dysfunction syndrome and septic shock in the first week and rapid vertebral destruction within 2 months of the patient’s admission. His obese status may be relevant to his presentation. This case report suggests that S. constellatus infections should not be overlooked, especially in patients with known risk factors and predispositions to infectious diseases.
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Affiliation(s)
- Yufei Jin
- Department of Spine Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xiang Yin
- Department of Spine Surgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China
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