Mycoplasma hominis cultured from cerebrospinal fluid after subarachnoid haemorrhage
Abstract number: R2558
Lee E.H.L., Winter H.L.J., Arends J.P.
Introduction: Urogenital colonization with Mycoplasma hominis is common in sexually active adolescent females. Extra-genitourinary infections caused by this species are described in the literature. However, it is still a rare pathogen cultured from cerebrospinal fluid.
Methods: A 48 years old woman was admitted because of a subarachnoid hemorrhage. Fever (39°C) was noted six days after craniotomy. On the ninth hospital day, blood cultures became positive with Staphylococcus aureus. Flucloxacillin intravenous and a combination of intravenous and intrathecal vancomycine were administered. This infection responded, however, 3 days later, she again developed high fever in spite of the antibiotics. After 6 days of incubation, small colonies were detected on blood agar from CSF taken on day 9, 16 and 17. There were no bacteria present on the Gram stain. No identification could be obtained by using MALDI-TOF MS. No growth was detected in seven CSF cultures before day 9 and 18 cultures after day 17.
Result:M. hominis was detected from CSF by using 16S rDNA gene amplification. Moxifloxacin (400 mg daily) was given intravenous for two weeks. Clinical conditions improved with negative repeat CSF cultures.
Conclusion: Amplification of 16S rDNA for M. hominis in CSF should be included in diagnostic workup of patients after subarachnoid hemorrhage. Clinicians should consider this rarely recognised pathogen in the differential by those not responding to standard therapy with negative results in routine bacterial cultures.
|Session name:||Abstracts of 21st ECCMID / 27th ICC|
|Location:||Milan, Italy, 7 - 10 May 2011|
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