Postoperative Mycoplasma hominis brain abscess: keep it in mind!

ABSTRACT: A temporal lobe abscess was diagnosed in a 57-year-old man. A urethral catheter had been inserted 12?days earlier, just prior to clot evacuation of a subacute haematoma secondary to an arterio-venous malformation. Fever persisted despite debridement and treatment with meropenem and vancomycin. Gram stains of operative samples showed no bacteria. Extended cultures grew pinpoint colonies after 5?days. Meanwhile, sequencing of bacterial 16S rDNA from operative specimens had identified Mycoplasma hominis; the bacterial colonies were subsequently similarly identified. The patient responded promptly following addition of oral doxycycline 100?mg two times per day. There is a growing literature of similar cases. Transient bacteraemia, following urinary catheterisation, with seeding of existing sites of inflammation is the proposed explanation. Urethral carriage of M. hominis is 15% and catheterisation is a common procedure. Mycoplasma hominis maybe more common than appreciated, especially as the need for extended cultures makes a correct diagnosis less likely.

SUBMITTER: Bergin SM 

PROVIDER: S-EPMC5255544 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature