Anaerobic meningitis due to Peptostreptococcus species: case report and review

Polymicrobial Anaerobic Meningitis Detected by Next-Generation Sequencing: Case Report and Review of the Literature

Background

Anaerobic meningitis is a severe central nervous system infection associated with significant neurological sequelae and high mortality. However, the precise detection of causative pathogen(s) remains difficult because anaerobic bacteria are difficult to culture. Next-generation sequencing is a technology that was developed recently and has been applied in many fields. To the best of our knowledge, the use of next-generation sequencing for cerebrospinal fluid analysis in the diagnosis of anaerobic meningitis has been rarely reported.

Case presentation

Here, we report a case of polymicrobial anaerobic meningitis diagnosed using next-generation sequencing of cerebrospinal fluid in a 16-year-old girl. Five species of anaerobic bacteria (Porphyromonas gingivalis, Prevotella enoeca, Campylobacter rectus, Fusobacterium uncleatum, and Actinomyces israelii) were detected by next-generation sequencing and treated with antibacterial agents (ceftriaxone, vancomycin, and metronidazole). The patient responded well to antibacterial treatment. Further inspection revealed bone destruction at the base of the skull, which further confirmed that these bacteria had originated from the oral cavity. One month later, the patient's condition improved significantly. At the same time, we performed a literature review on anaerobic meningitis using studies published in the last 20 years.

Conclusions

This case emphasizes the importance of applying metagenomic next-generation sequencing to clinch the clinical diagnosis for patients with central nervous system infection. Metagenomic next-generation sequencing has been reported to be an important diagnostic modality for identifying uncommon pathogens.

Subdural empyema caused by Peptostreptococcus sp.: a complication of acute pharyngitis

Subdural Empyema (ESD) is the collection of purulent fluid that develops between the exterior "dura mater" layer and the middle "arachnoid mater" layer that covers the brain. ESD can be caused by a primary infection located in the paranasal sinuses. In many aerobic and/or anaerobic bacterial cases, hearing or traumatic processes serve as the causative agent. This report presents pharyngitis in a young girl which later developed into a subdural empyema caused by the bacteria Peptostreptococcus sp. The report emphasizes the correct clinical valuation of pharyngitis as a risk factor for developing subdural empyema in children.

Polymicrobial meningitis revealing an anterior sacral meningocele in a 23-year-old woman

Polymicrobial meningitis has become increasingly rare during recent decades. Historically, it has mainly been reported as being associated with disorders of the ENT-sphere. The treatment of these infections being optimized, polymicrobial meningitis nowadays is essentially a complication of gastrointestinal or gynaecological disorders and trauma. We present a case of polymicrobial meningitis following puncture of a unrecognized pre-sacral meningocele in a patient with Currarino syndrome and review of the relevant literature.