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Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses
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 o...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294173/ https://www.ncbi.nlm.nih.gov/pubmed/32547827 http://dx.doi.org/10.25259/SNI_20_2020 |
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author | Prieto, Ruth Callejas-Díaz, Alejandro Hassan, Rasha de Vargas, Alberto Pérez López-Pájaro, Luis Fernando |
author_facet | Prieto, Ruth Callejas-Díaz, Alejandro Hassan, Rasha de Vargas, Alberto Pérez López-Pájaro, Luis Fernando |
author_sort | Prieto, Ruth |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7294173 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-72941732020-06-15 Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses Prieto, Ruth Callejas-Díaz, Alejandro Hassan, Rasha de Vargas, Alberto Pérez López-Pájaro, Luis Fernando Surg Neurol Int Case Report 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. Scientific Scholar 2020-06-06 /pmc/articles/PMC7294173/ /pubmed/32547827 http://dx.doi.org/10.25259/SNI_20_2020 Text en Copyright: © 2020 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Prieto, Ruth Callejas-Díaz, Alejandro Hassan, Rasha de Vargas, Alberto Pérez López-Pájaro, Luis Fernando Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title | Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title_full | Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title_fullStr | Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title_full_unstemmed | Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title_short | Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
title_sort | parvimonas micra: a potential causative pathogen to consider when diagnosing odontogenic brain abscesses |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294173/ https://www.ncbi.nlm.nih.gov/pubmed/32547827 http://dx.doi.org/10.25259/SNI_20_2020 |
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