Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis

B. Kocsis, Zoltán Tiszlavicz, Gabriella Jakab, Réka Brassay, Márton Orbán, Ágnes Sárkány, D. Szabó

Research output: Contribution to journalArticle

Abstract

Background: Central nervous system (CNS) infections caused by Actinomyces spp. including brain abscess, actinomycoma, subdural empyema and epidural abscess are well described, however reports of Actinomyces-associated meningitis are scarcely reported. Case report: We present the case of a 43-year-old Hungarian male patient with poor socioeconomic status who developed acute bacterial meningitis caused by Actinomyces turicensis originating from the left side mastoiditis. The bacterial cultures of both cerebrospinal fluid (CSF) and purulent discharge collected during the mastoid surgery showed slow growing Gram-positive rods that were identified by automated systems (API, VITEK) as A. turicensis The bacterial identification was confirmed by 16S rRNA PCR and subsequent nucleic acid sequencing. No bacterial growth was detected in blood culture bottles after 5 days of incubation. Hence, multiple antibacterial treatments and surgical intervention the patient passed away. Conclusions: Anaerobes are rarely involved in CNS infections therefore anaerobic culture of CSF samples is routinely not performed. However, anaerobic bacteria should be considered as potential pathogens when certain risk factors are present, such as paranasal sinusitis, mastoiditis in patients with poor socioeconomic condition. To the best of our knowledge, our case report is the first description of A. turicensis meningitis that has been diagnosed as consequence of purulent mastoiditis.

Original languageEnglish
Article number686
JournalBMC Infectious Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - Dec 20 2018

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Mastoiditis
Actinomyces
Meningitis
Central Nervous System Infections
Cerebrospinal Fluid
Subdural Empyema
Gram-Positive Rods
Epidural Abscess
Brain Abscess
Mastoid
Bacterial Meningitides
Anaerobic Bacteria
Sinusitis
Social Class
Nucleic Acids
Polymerase Chain Reaction
Growth
Therapeutics

Keywords

  • Actinomyces turicensis
  • Anaerobic culture
  • Cerebrospinal fluid
  • Mastoiditis
  • Meningitis
  • Poor socioeconomic condition

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis. / Kocsis, B.; Tiszlavicz, Zoltán; Jakab, Gabriella; Brassay, Réka; Orbán, Márton; Sárkány, Ágnes; Szabó, D.

In: BMC Infectious Diseases, Vol. 18, No. 1, 686, 20.12.2018.

Research output: Contribution to journalArticle

Kocsis, B. ; Tiszlavicz, Zoltán ; Jakab, Gabriella ; Brassay, Réka ; Orbán, Márton ; Sárkány, Ágnes ; Szabó, D. / Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis. In: BMC Infectious Diseases. 2018 ; Vol. 18, No. 1.
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