and Coinfection of Brain: An Unusual Case from China

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2024 Apr 17

PMID 38628241

Authors

Lei Yuan

Lan Min Lai

Xinyu Zhu

Zhao Rui

Yang Liu

Qiang Chen

Affiliations

Soon will be listed here.

Abstract

Background: The HACEK group comprises spp., , , , and , are Gram-negative bacteria that are slow-growing and fastidious. These organisms are common causes of culture-negative endocarditis. However, brain abscesses caused by and have been rarely reported. The case we describe, which was promptly identified and successfully treated, will be meaningful for the diagnosis and treatment of such infectious diseases.

Case Presentation: Herein, we report a case of brain abscess in a young man who was infected with and . The patient was admitted to the hospital with sudden onset of vomiting, coma, and fever. Magnetic resonance imaging (MRI) of the brain and cerebrospinal fluid cell counts suggested cerebral abscess, he underwent drainage of the abscess and empirical antimicrobial therapy of meropenem (2 g every 8 hours) and linezolid (0.6 g every 12 hours) for more than 10 days without significant improvement. Metagenomic next-generation sequencing (mNGS) of drainage fluid and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) detection for isolated bacteria from samples suggested the presence of and . After 7 weeks of ceftriaxone (2 g every 12 hours) and meropenem (2 g every 8 hours) intravenously, the patient was discharged with a normal temperature and brain MRI showed improvement of the lesion.

Conclusion: Similar cases reported in previous studies were always associated with bacterial blood dissemination after dental surgery or myocarditis; however, the patient in our case had no any associated risk factors. As far as we know, this is the only case of central nervous system infection caused by and that has utilized combined mNGS and MALDI-TOF MS in the diagnosis.

References

Abla A, Maroon J, SLIFKIN M . Brain abscess due to Haemophilus aphrophilus: possible canine transmission. Neurosurgery. 1986; 19(1):123-4. DOI: 10.1227/00006123-198607000-00021. View

Wilson M, Sample H, Zorn K, Arevalo S, Yu G, Neuhaus J . Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis. N Engl J Med. 2019; 380(24):2327-2340. PMC: 6764751. DOI: 10.1056/NEJMoa1803396. View

Liao Y, Luo C, Ko W, Chen P . Aggregatibacter aphrophilus culture-negative endocarditis diagnosed by 16S rRNA gene sequencing in excised mitral valve - A case report. J Microbiol Immunol Infect. 2017; 50(4):557-558. DOI: 10.1016/j.jmii.2016.10.002. View

Papa A, Kotrotsiou T, Papadopoulou E, Reusken C, GeurtsvanKessel C, Koopmans M . Challenges in laboratory diagnosis of acute viral central nervous system infections in the era of emerging infectious diseases: the syndromic approach. Expert Rev Anti Infect Ther. 2016; 14(9):829-36. DOI: 10.1080/14787210.2016.1215914. View

Yamashita J, Bone F, Hitchcock E . Brain abscess due to Haemophilus aphrophilus: case report. J Neurol Neurosurg Psychiatry. 1972; 35(6):909-11. PMC: 494204. DOI: 10.1136/jnnp.35.6.909. View

van Veen S, Claas E, Kuijper E . High-throughput identification of bacteria and yeast by matrix-assisted laser desorption ionization-time of flight mass spectrometry in conventional medical microbiology laboratories. J Clin Microbiol. 2010; 48(3):900-7. PMC: 2832429. DOI: 10.1128/JCM.02071-09. View

Jaramillo-Lanchero R, Suarez-Alvarez P, Teheran-Sierra L . Effect of respiratory inhibitors and quinone analogues on the aerobic electron transport system of Eikenella corrodens. Sci Rep. 2021; 11(1):8987. PMC: 8076288. DOI: 10.1038/s41598-021-88388-0. View

van Belkum A, Welker M, Erhard M, Chatellier S . Biomedical mass spectrometry in today's and tomorrow's clinical microbiology laboratories. J Clin Microbiol. 2012; 50(5):1513-7. PMC: 3347093. DOI: 10.1128/JCM.00420-12. View

Miller D, Fung M, Carbo A . A Furry Friend's Dirty Mouth: Brain Abscess Due to Aggregatibacter (Haemophilus) aphrophilus. Am J Med. 2017; 130(10):e447-e448. DOI: 10.1016/j.amjmed.2017.04.020. View

10.

Norskov-Lauritsen N . Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev. 2014; 27(2):214-40. PMC: 3993099. DOI: 10.1128/CMR.00103-13. View

11.

Miller S, Naccache S, Samayoa E, Messacar K, Arevalo S, Federman S . Laboratory validation of a clinical metagenomic sequencing assay for pathogen detection in cerebrospinal fluid. Genome Res. 2019; 29(5):831-842. PMC: 6499319. DOI: 10.1101/gr.238170.118. View

12.

Maraki S, Papadakis I, Chronakis E, Panagopoulos D, Vakis A . Aggregatibacter aphrophilus brain abscess secondary to primary tooth extraction: Case report and literature review. J Microbiol Immunol Infect. 2014; 49(1):119-22. DOI: 10.1016/j.jmii.2013.12.007. View

13.

Shruthi U, Prabhu Raj A, Kumari H B V, Nagarathna C . Anaerobic bacteriological profile of brain abscess in a tertiary care center in southern India. Anaerobe. 2019; 59:68-71. DOI: 10.1016/j.anaerobe.2019.05.012. View

14.

Belkacem A, Caseris M, Yazdanpanah Y . A Case of Aggregatibacter aphrophilus Multiple Abscess. Open Forum Infect Dis. 2015; 2(2):ofv031. PMC: 4566307. DOI: 10.1093/ofid/ofv031. View

15.

Chien Y, Huang Y, Liao C, Chien J, Hsueh P . Clinical characteristics of bacteremia caused by Haemophilus and Aggregatibacter species and antimicrobial susceptibilities of the isolates. J Microbiol Immunol Infect. 2021; 54(6):1130-1138. DOI: 10.1016/j.jmii.2020.12.002. View

16.

Lo Biundo C, Bongiovanni A, Tumbiolo S, Sucato A, Fasciana T, Giammanco A . Aggregatibacter aphrophilus and Eikenella corrodens: a case of brain abscess. New Microbiol. 2023; 46(2):216-218. View

17.

Revest M, Egmann G, Cattoir V, Tattevin P . HACEK endocarditis: state-of-the-art. Expert Rev Anti Infect Ther. 2016; 14(5):523-30. DOI: 10.1586/14787210.2016.1164032. View

18.

Tok S, Neidert M, Bloemberg G, Surucu O . Aggregatibacter aphrophilus ventriculitis following C1-C2 transarticular screw fixation. Neurol Neurochir Pol. 2016; 50(1):63-8. DOI: 10.1016/j.pjnns.2015.11.005. View

19.

Goncalves R, Murinello A, da Silva S, Coelho J, Santos A, Sa Damasio H . Hepatic Abscess due to and , Secondary to Gastric Perforation by a Fish Bone. GE Port J Gastroenterol. 2019; 26(6):414-419. PMC: 6876602. DOI: 10.1159/000497333. View

20.

Chen X, Hou X, Xiao M, Zhang L, Cheng J, Zhou M . Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) Analysis for the Identification of Pathogenic Microorganisms: A Review. Microorganisms. 2021; 9(7). PMC: 8304613. DOI: 10.3390/microorganisms9071536. View