Eikenella Corrodens, Fusobacterium Nucleatum and Parvimonas Micra: A Case of Polymicrobial Brain Abscess

Waad Al Saleemi¹, Amal Al Balushi¹, Ahmed AlAzri², Mustafa Al Shaaibi³, Amina Al-Jardani⁴, Azza Al Rashdi⁴, Khalsa Al Ramadhani⁵, Hala Al Hinai⁶ and Nawal Al Kindi^6,

¹Medical Microbiology, Oman Medical Speciality Board (OMSB), Oman, Muscat

²Neurosurgery Department, Khoula Hospital, Oman, Muscat

³Internal Medicine Department (Infection Disease), Al Nahdha Hospital, Oman, Muscat

⁴Central Public Health Laboratories,Ministry Of Health, Oman, Muscat

⁵Radiology Department, Khoula Hospital, Oman, Muscat

⁶Medical Microbiology Department, Khoula Hospital, Oman, Muscat

Cite this paper

Waad Al Saleemi, Amal Al Balushi, Ahmed AlAzri, Mustafa Al Shaaibi, Amina Al-Jardani, Azza Al Rashdi, Khalsa Al Ramadhani, Hala Al Hinai and Nawal Al Kindi. Eikenella Corrodens, Fusobacterium Nucleatum and Parvimonas Micra: A Case of Polymicrobial Brain Abscess. American Journal of Medical Case Reports. 2024; 12(3):42-45. doi: 10.12691/AJMCR-12-3-4

Abstract

Brain abscess represents one of the most serious complication of head and neck infections. While anaerobic bacteria are frequent isolates from brain abscesses, usually in a mixed culture, Eikenella corrodens is rarely isolated from this site. E. corrodens is a fastidious gram-negative bacterium that normally colonizes the oral cavity and upper respiratory tract. We report a case of a 42-year-old immunocompetent lady with a background of Ebstein cardiac anomaly who presented with parietooccipital brain abscess. She underwent awake surgery under navigation guidance, burr hole drainage of the abscess. Abscess culture revealed growth of E. corrodens in addition to anaerobic bacterial growth of Fusobacterium nucleatum and Parvimonas micra. The patient was successfully treated with a six weeks course of intravenous ceftriaxone and metronidazole which resulted in complete resolution of the abscess.

Keywords

brain abscess, eikenella corrodens, fusobacterium nucleatum, parvimonas micra, polymicrobial infection, oral flora

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Huang, J., Wu, H., Huang, H., Wu, W., Wu, B., & Wang, L. (2021). Clinical characteristics and outcome of primary brain abscess: a retrospective analysis. BMC Infectious Diseases, 21(1), 1-8.‏
[2]	Brouwer, M. C., Tunkel, A. R., & McKhann, G. M. (2014). II, van de Beek D. Brain abscess. N Engl J Med, 371(5), 447-456.‏
[3]	Morris, N. A., Matiello, M., Lyons, J. L., & Samuels, M. A. (2014). Neurologic complications in infective endocarditis: identification, management, and impact on cardiac surgery. The Neurohospitalist, 4(4), 213-222.‏
[4]	McClelland III, S., & Hall, W. A. (2007). Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures. Clinical Infectious Diseases, 45(1), 55-59.‏
[5]	Bodilsen, J., Dalager-Pedersen, M., Van de Beek, D., Brouwer, M. C., & Nielsen, H. (2020). Incidence and mortality of brain abscess in Denmark: a nationwide population-based study. Clinical Microbiology and Infection, 26(1), 95-100.‏
[6]	Emmerson, A. M., & Mills, F. (1978). Recurrent meningitis and brain abscess caused by Eikenella corrodens. Postgraduate medical journal, 54(631), 343.‏
[7]	Goldstein, E. J., Citron, D. M., Merriam, C. V., Warren, Y. A., Tyrrell, K. L., & Fernandez, H. (2002). In vitro activities of a new des-fluoroquinolone, BMS 284756, and seven other antimicrobial agents against 151 isolates of Eikenella corrodens. Antimicrobial agents and chemotherapy, 46(4), 1141-1143.
[8]	Chen, K. C., Sun, J. M., & Hsieh, C. T. (2023). Brain abscess caused by Parvimonas micra: a rare case report and literature review. Anaerobe, 80, 102711.‏
[9]	Akashi, M., Tanaka, K., Kusumoto, J., Furudoi, S., Hosoda, K., & Komori, T. (2017). Brain abscess potentially resulting from odontogenic focus: report of three cases and a literature review. Journal of maxillofacial and oral surgery, 16, 58-64.‏
[10]	Takahashi, M., Nakanishi, Y., Hamada, Y., Hoshimoto, Y., Aoki, J., & Karakida, K. (2020). A case of brain abscess caused by Actinomyces cardiffensis and Parvimonas micra. Tokai J Exp Clin Med, 45(4), 189-94.‏
[11]	Prieto, R., Callejas-Díaz, A., Hassan, R., de Vargas, A. P., & López-Pájaro, L. F. (2020). Parvimonas micra: A potential causative pathogen to consider when diagnosing odontogenic brain abscesses. Surgical Neurology International, 11.‏
[12]	Cesta, N., Biland, L. F., Neri, B., Mossa, M., Campogiani, L., Caldara, F., ... & Sarmati, L. (2021). Multiple hepatic and brain abscesses caused by Parvimonas micra: a case report and literature review. Anaerobe, 69, 102366.‏
[13]	Januário, G., Diaz, R., & Nguewa, P. (2021). Brain Abscess Caused by Parvimonas Micra with Successful Treatment: A Rare Case Report. Frontiers in Medical Case Reports, 2, 1-09.‏
[14]	Kim, E. Y., Baek, Y. H., Jung, D. S., & Woo, K. S. (2019). Concomitant liver and brain abscesses caused by Parvimonas micra. The Korean Journal of Gastroenterology, 73(4), 230-234.‏
[15]	Kwon, O., Uh, Y., Jang, I. H., Lee, H. G., Yoon, K. J., Kim, H. Y., & Han, Y. P. (2009). A case of brain abscess due to Parvimonas micra. Korean Journal of Clinical Microbiology, 12(3), 129-132.‏
[16]	Watanabe, T., Hara, Y., Yoshimi, Y., Fujita, Y., Yokoe, M., & Noguchi, Y. (2020). Clinical characteristics of bloodstream infection by Parvimonas micra: retrospective case series and literature review. BMC Infectious Diseases, 20, 1-8.‏‏
[17]	Chen Y, Huang Z, Tang Z, Huang Y, Huang M, Liu H, et al. More Than Just a Periodontal Pathogen –the Research Progress on Fusobacterium nucleatum. Front Cell Infect Microbiol . 2022 Feb 3 [cited 2024 Feb 14];12:815318. Available from: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC8851061/.Frontiers in Cellular and Infection Microbiology, 12, 64.‏
[18]	De Andres Crespo, M., McKinnon, C., & Halliday, J. (2020). What you need to know about brain abscesses. British Journal of Hospital Medicine, 81(8), 1-7.‏
[19]	Laarif, M. L., Schils, R., Lifrange, F., Valkenborgh, C., Pitti, P., Brouwers, P., ... & Hayette, M. P. (2023). Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report. Access Microbiology, 5(6), 000499-v4.
[20]	Hsu, G., Zhang, J., Selvi, F., Shady, N., & August, M. (2020). Do brain abscesses have a higher incidence of odontogenic origin than previously thought. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 130(1), 10-17.‏
[21]	Moazzam, A. A., Rajagopal, S. M., Sedghizadeh, P. P., Zada, G., & Habibian, M. (2015). Intracranial bacterial infections of oral origin. Journal of Clinical Neuroscience, 22(5), 800-806.