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Shao A, He Q, Jiao X, Liu J. Hemoptysis caused by Parvimonas micra: case report and literature review. Front Public Health 2024; 11:1307902. [PMID: 38389952 PMCID: PMC10883377 DOI: 10.3389/fpubh.2023.1307902] [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: 10/05/2023] [Accepted: 12/29/2023] [Indexed: 02/24/2024] Open
Abstract
Background Parvimonas micra (P. micra), a Gram-positive anaerobic bacterium, exhibits colonization tendencies on oral mucosal and skin surfaces, potentially evolving into a pathogenic entity associated with diverse diseases. The diagnostic trajectory for P. micra-related diseases encounters delays, often with severe consequences, including fatality, attributed to the absence of symptom specificity and challenges in culture. The absence of a consensus on the diagnostic and therapeutic approaches to P. micra exacerbates the complexity of addressing associated conditions. This study aims to elucidate and scrutinize the clinical manifestations linked to P. micra, drawing insights from an extensive literature review of pertinent case reports. Case presentation A 53-year-old male sought medical attention at our institution presenting with recurrent hemoptysis. Empirical treatment was initiated while awaiting pathogen culture results; however, the patient's symptoms persisted. Subsequent metagenomic next-generation sequencing (mNGS) analysis revealed a pulmonary infection attributable to P. micra. Resolution of symptoms occurred following treatment with piperacillin sulbactam sodium and moxifloxacin hydrochloride. A comprehensive literature review, utilizing the PubMed database, was conducted to assess case reports over the last decade where P. micra was identified as the causative agent. Conclusion The literature analysis underscores the predilection of P. micra for immunocompromised populations afflicted by cardiovascular diseases, diabetes, orthopedic conditions, and tumors. Risk factors, including oral and periodontal hygiene, smoking, and alcohol consumption, were found to be associated with P. micra infections. Clinical manifestations encompassed fever, cough, sputum production, and back pain, potentially leading to severe outcomes such as Spondylodiscitis, septic arthritis, lung abscess, bacteremia, sepsis, and mortality. While conventional bacterial culture remains the primary diagnostic tool, emerging technologies like mNGS offer alternative considerations. In terms of treatment modalities, β-lactam antibiotics and nitroimidazoles predominated, exhibiting recovery rates of 56.10% (46/82) and 23.17% (19/82), respectively. This case report and literature review collectively aim to enhance awareness among clinicians and laboratory medicine professionals regarding the intricacies of P. micra-associated infections.
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Affiliation(s)
- Axue Shao
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qingqing He
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Jiao
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianbo Liu
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
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2
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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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3
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Chen KC, Sun JM, Hsieh CT. Brain abscess caused by Parvimonas micra: A rare case report and literature review. Anaerobe 2023; 80:102711. [PMID: 36736989 DOI: 10.1016/j.anaerobe.2023.102711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
Brain abscesses mostly develop due to direct infection caused by a nearby infectious lesion or hematogenous spread and are rarely caused by an odontogenic infection. We report a 47-year-old woman who presented with high fever, disturbed consciousness, headache, and neck pain. Imaging studies revealed a ring-shaped enhanced mass in the left frontal lobe causing a mass effect and midline shift. Magnetic resonance spectroscopy revealed a peak alanine concentration of 1.5 ppm. Supraorbital keyhole surgery with abscess removal was performed, and a bacterial culture confirmed a diagnosis of Parvimonas micra infection. After undergoing 6-week antibiotic treatment, the patient's symptoms resolved completely. No recurrence of abscess was observed during the follow-up period. Although brain abscess caused by P. micra has rarely been reported, an odontogenic origin should be investigated, especially when a patient has a history of periodontal infection or tooth extraction.
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Affiliation(s)
- Kuan-Chi Chen
- Department of Surgery, Cathay General Hospital, Taipei City, 106, Taiwan.
| | - Jui-Ming Sun
- Section of Neurosurgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan; Department of Biotechnology, Asia University, Taichung City, 41354, Taiwan.
| | - Cheng-Ta Hsieh
- Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei City, 22174, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, 300044, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, 24205, Taiwan.
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4
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Feng Y, Wu C, Huang X, Huang X, Peng L, Guo R. Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia. Front Med (Lausanne) 2022; 9:1017074. [DOI: 10.3389/fmed.2022.1017074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Parvimonas micra is an anaerobic Gram-positive coccus frequently found in the oral cavity and gastrointestinal tract, but rarely in the lung. Therefore, pneumonia caused by P. micra is also rare. Although there are some reports of P. micra related pneumonia due to aspiration or blood-borne infection with definite remote infection source, there are no reported cases of hematogenous P. micra pneumonia in healthy adults lacking a remote source of infection. Herein, we described the intact disease of P. micra-related pneumonia mimicking hematogenous Staphylococcus aureus pneumonia in terms of chest imagery and diagnosed via metagenomic next-generation sequencing (mNGS). Interestingly, there was no clear remote pathogenic source identified in the patient. Microbiome analysis revealed dysbiosis of the oral flora possibly related to poor oral hygiene and a long history of smoking. The patient was treated with moxifloxacin for 3 months. Ultimately, computed tomography (CT) of the chest showed total resolution of the lung lesion. Clinicians need to update the etiology of community-acquired pneumonia. When antibiotic therapy is not effective, pathogen examination becomes very important. New methods of pathogen detection such as mNGS should be employed to this end. For the treatment of P. micra pneumonia, no standardized course of treatment was reported. Imaging absorption of lung infections may provide a more objective guidance for the duration of antibiotics in P. micra pneumonia.
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5
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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.
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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
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6
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Ho A, Duvapu B, Duong N, Samantara S. First Case of Splenic Abscess Parvimonas micra and Bacteremia Porphyromonas gingivalis Coinfection. Cureus 2022; 14:e28103. [PMID: 36127960 PMCID: PMC9480488 DOI: 10.7759/cureus.28103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
We report a case of a 76-year-old Caucasian male with bacteremia caused by Porphyromonas gingivalis and splenic abscess caused by Parvimonas micra. This patient presented with nonspecific symptoms: fever, chills, body aches, and shortness of breath. He was treated with IV piperacillin-tazobactam that was later switched to ampicillin sodium/sulbactam sodium during his hospital course and underwent a splenectomy. He ultimately expired due to acute respiratory failure and cardiac arrest, secondary to post-surgical complications. To our knowledge, this is the first case of P. micra and P. gingivalis coinfection.
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Development of the First Tractable Genetic System for Parvimonas micra, a Ubiquitous Pathobiont in Human Dysbiotic Disease. Microbiol Spectr 2022; 10:e0046522. [PMID: 35416697 PMCID: PMC9045310 DOI: 10.1128/spectrum.00465-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Parvimonas micra is a Gram-positive obligate anaerobe and a typical member of the human microbiome. P. micra is among the most highly enriched species at numerous sites of mucosal dysbiotic disease and is closely associated with the development of multiple types of malignant tumors. Despite its strong association with disease, surprisingly little is known about P. micra pathobiology, which is directly attributable to its longstanding genetic intractability. To address this problem, we directly isolated a collection of P. micra strains from odontogenic abscess clinical specimens and then screened these isolates for natural competence. Amazingly, all of the P. micra clinical isolates exhibited various levels of natural competence, including the reference strain ATCC 33270. By exploiting this ability, we were able to employ cloning-independent methodologies to engineer and complement a variety of targeted chromosomal genetic mutations directly within low-passage-number clinical isolates. To develop a tractable genetic system for P. micra, we first adapted renilla-based bioluminescence for highly sensitive reporter studies. This reporter system was then applied for the development of the novel Theo+ theophylline-inducible riboswitch for tunable gene expression studies over a broad dynamic range. Finally, we demonstrate the feasibility of generating mariner-based transposon sequencing (Tn-seq) libraries for forward genetic screening in P. micra. With the availability of a highly efficient transformation protocol and the current suite of genetic tools, P. micra should now be considered a fully genetically tractable organism suitable for molecular genetic research. The methods presented here provide a clear path to investigate the understudied role of P. micra in polymicrobial infections and tumorigenesis. IMPORTANCE Parvimonas micra is among the most highly enriched species at numerous sites of mucosal dysbiotic disease and is closely associated with numerous cancers. Despite this, little is known about P. micra pathobiology, which is directly attributable to its longstanding genetic intractability. In this study, we provide the first report of P. micra natural competence and describe the only tractable genetic system for this species. The methods presented here will allow for the detailed study of P. micra and its role in infection and tumorigenesis.
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8
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P. micra and F. necrophorum: Hepatic Abscesses in a Healthy Soldier. Case Rep Infect Dis 2022; 2022:5500365. [PMID: 35345475 PMCID: PMC8957035 DOI: 10.1155/2022/5500365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/26/2022] [Indexed: 12/04/2022] Open
Abstract
Parvimonas micra (P. micra) and Fusobacterium necrophorum (F. necrophorum) are two pathogens known to cause odontogenic and oropharyngeal infections. It is exceedingly rare for these bacteria to cause coinfection and even systemic infection. There is limited literature on liver abscesses and bacteremia involving P. micra. Most cases are found in elderly patients with associated gastrointestinal malignancy (24%) or laryngeal pharynx malignancy (28%). However, a substantial portion of described cases were unable to identify a source (36%). A 36-year-old, otherwise healthy male presented for fevers and chills for 2 weeks. After testing negative for initial infectious workup, including COVID-19 multiple times, he was found to have multiple liver abscesses which grew P. micra and F. necrophorum. This case highlights a rare coinfection of hepatic abscesses in an otherwise healthy young immunocompetent adult with a solitary dental caries, resulting in septic shock.
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9
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Anaerobe coverage is important for the prognosis of pyogenic liver abscess: A population-based study in Korea. J Infect Public Health 2022; 15:425-432. [DOI: 10.1016/j.jiph.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 01/13/2023] Open
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10
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Understanding of the Site-Specific Microbial Patterns towards Accurate Identification for Patients with Diarrhea-Predominant Irritable Bowel Syndrome. Microbiol Spectr 2021; 9:e0125521. [PMID: 34937163 PMCID: PMC8694097 DOI: 10.1128/spectrum.01255-21] [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] [Indexed: 12/20/2022] Open
Abstract
Fecal microbial community could not fully represent the intestinal microbial community. However, most studies analyzing diarrhea-dominant irritable bowel syndrome (IBS-D) were mainly based on fecal samples. We aimed to characterize the IBS-D microbial community patterns using samples at multiple intestinal sites. This study recruited 74 IBS-D patients and 20 healthy controls (HC). 22.34%, 8.51%, 14.89%, and 54.26% of them contributed to one, two, three, and four sites: duodenal mucosa (DM), duodenal lumen (DL), rectal mucosa (RM), and rectal lumen (RL) of intestinal samples, respectively. Then 16S rRNA gene analysis was performed on these 283 samples. The result showed that IBS-D microbial communities have specific patterns at each intestinal site differing from that of HC. Across hosts and sites, Bacillus, Burkholderia, and Faecalibacterium were the representative genera in duodenum of IBS-D, duodenum of HC, and rectum of HC, respectively. Samples from mucosa and lumen in rectum were highly distinguishable, regardless of IBS-D and HC. Additionally, IBS-D patients have lower microbial co-abundance network connectivity. Moreover, RM site-specific biomarker: Bacteroides used alone or together with Prevotella and Oscillospira in RM showed outstanding performance in IBS-D diagnosis. Furthermore, Bacteroides and Prevotella in RM were strongly related to the severity of abdominal pain, abdominal discomfort, and bloating in IBS-D patients. In summary, this study also confirmed fecal microbial community could not fully characterize intestinal microbial communities. Among these site-specific microbial communities, RM microbial community would be more applicable in the diagnosis of IBS-D. IMPORTANCE Microbial community varied from one site to another along the gastrointestinal tract, but current studies about intestinal microbial community in IBS-D were mainly based on fecal samples. Based on 283 intestinal samples collected from DM, DL, RM, and RL of HC and IBS-D, we found different intestinal sites had their site-specific microbial patterns in IBS-D. Notably, RM site-specific microbes Bacteroides, Prevotella, and Oscillospira could be used to discriminate IBS-D from HC accurately. Our findings could help clinicians realize the great potential of the intestinal microbial community in RM for better diagnosis of IBS-D patients.
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Cesta N, Foroghi Biland L, Neri B, Mossa M, Campogiani L, Caldara F, Zordan M, Petruzziello C, Monteleone G, Fontana C, Andreoni M, Sarmati L. Multiple hepatic and brain abscesses caused by Parvimonas micra: A case report and literature review. Anaerobe 2021; 69:102366. [PMID: 33862204 DOI: 10.1016/j.anaerobe.2021.102366] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
Gram-positive anaerobic cocci (GPAC) are responsible for 30% of anaerobic infections. Parvimonas micra is an emergent pathogen that is part of the oral and gastrointestinal commensal flora, and its role in several infection processes has recently emerged thanks to the improvement of diagnostic techniques. P. micra bacteraemia is reported in immunocompromised patients and is often complicated by abscesses. Here, we present a case study of multiple hepatic and brain abscesses caused by P. micra bacteraemia in a patient with complicated diverticulitis.
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Affiliation(s)
- N Cesta
- Department of System Medicine, University of Rome "Tor Vergata", Rome, Italy; Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - L Foroghi Biland
- Department of System Medicine, University of Rome "Tor Vergata", Rome, Italy; Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - B Neri
- Department of Medicine, Gastrointestinal Unit, University of Rome "Tor Vergata", Rome, Italy
| | - M Mossa
- Department of Medicine, Gastrointestinal Unit, University of Rome "Tor Vergata", Rome, Italy
| | - L Campogiani
- Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - F Caldara
- Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - M Zordan
- Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - C Petruzziello
- Department of Medicine, Gastrointestinal Unit, University of Rome "Tor Vergata", Rome, Italy
| | - G Monteleone
- Department of Medicine, Gastrointestinal Unit, University of Rome "Tor Vergata", Rome, Italy
| | - C Fontana
- Department of Experimental Medicine and Surgery, Unit of Microbiology and Virology, University Hospital "Tor Vergata", Rome, Italy
| | - M Andreoni
- Department of System Medicine, University of Rome "Tor Vergata", Rome, Italy; Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy
| | - L Sarmati
- Department of System Medicine, University of Rome "Tor Vergata", Rome, Italy; Infectious Diseases Clinic, University Hospital "Tor Vergata", Rome, Italy.
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12
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Yu Q, Sun L, Xu Z, Fan L, Du Y. Severe pneumonia caused by Parvimonas micra: a case report. BMC Infect Dis 2021; 21:364. [PMID: 33865326 PMCID: PMC8052845 DOI: 10.1186/s12879-021-06058-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset. CASE PRESENTATION A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient's bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved. CONCLUSION In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.
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Affiliation(s)
- Qing Yu
- Department of Intense Care Unit, Shenzhen Longhua Central Hospital, Guanlan Boulevard, Shenzhen, 187, China.
| | - Lingling Sun
- Department of Intense Care Unit, Shenzhen Longhua Central Hospital, Guanlan Boulevard, Shenzhen, 187, China.,Department of Anesthesiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Taoyuan Road 89, Shenzhen, China
| | - Zuqing Xu
- Department of Intense Care Unit, Shenzhen Longhua Central Hospital, Guanlan Boulevard, Shenzhen, 187, China
| | - Lumei Fan
- Department of Intense Care Unit, Shenzhen Longhua Central Hospital, Guanlan Boulevard, Shenzhen, 187, China
| | - Yunbo Du
- Department of Intense Care Unit, Shenzhen Longhua Central Hospital, Guanlan Boulevard, Shenzhen, 187, China
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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.
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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
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14
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Prieto R, Callejas-Díaz A, Hassan R, de Vargas AP, López-Pájaro LF. Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses. Surg Neurol Int 2020; 11:140. [PMID: 32547827 PMCID: PMC7294173 DOI: 10.25259/sni_20_2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Brain abscess is a life-threatening entity which requires prompt and long-term antibiotic therapy, generally associated with surgical drainage, and eradicating the primary source of infection. Parvimonas micra (Pm) has only been reported once before as the lone infecting organism of an orally originated, solitary brain abscess. Diagnosing brain abscesses caused by this Gram-positive anaerobic coccus, constituent of the oral cavity flora, is challenging, and an optimal treatment regimen has not been well established. We report the diagnosis and successful treatment of a Pm caused odontogenic brain abscess. Case Description: A 62-year-old immunocompetent male with a right-parietal brain abscess presented with headache and seizures. He was started on empirical antibiotic therapy and subsequently underwent surgical drainage. The only source of infection found was severe periodontitis with infected mandibular cysts. Thus, tooth extraction and cyst curettage were performed 1 week after brain surgery. Cultures of brain abscess fluid were negative, but amplification of bacterial 16S ribosomal RNA (rRNA) with polymerase chain reaction demonstrated Pm. After 3 weeks of intravenous ceftriaxone and metronidazole, the patient was switched to oral metronidazole and moxifloxacin for 6 weeks. Conclusions: This case highlights the potential risk of untreated dental infections causing brain abscesses. Pm should be considered as a possible pathogen of odontogenic brain abscesses despite its presence usually not being detected by standard bacterial cultures. Therefore, 16S rRNA gene sequencing analysis is strongly recommended for bacterial identification before defining brain abscesses as cryptogenic.
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Affiliation(s)
- Ruth Prieto
- Departments of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain
| | | | - Rasha Hassan
- Departments of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain
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García-Hita M, Sigona-Giangreco IA, Rincón-Almanza A, Frasquet-Artes J. Parvimonas micra infective endocarditis. Enferm Infecc Microbiol Clin 2020; 38:449-450. [PMID: 32098702 DOI: 10.1016/j.eimc.2020.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Marta García-Hita
- Servicio de Microbiología, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
| | | | | | - Juan Frasquet-Artes
- Servicio de Microbiología, Hospital Universitario y Politécnico la Fe, Valencia, Spain
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