Abstract
Streptococcal Species is increasingly recognized as a potentially preventable emerging infection in human’s brain with high prevalence around the world. Streptococcus constellatus is one of the most common pathogens. Meanwhile, anaerobic bacteria are the rare causes for intracranial infection. To date, intracranial mixed infection caused by Prevotella intermedia and Streptococcus constellatus has not been reported. We reported a Chinese case to raise the global awareness of severity of the intracranial mixed infection. Here, we illustrated the epidemiological risk factors, clinical manifestations and outcomes of the patient. For patients who suffer from exacerbated brain infection with fetid cerebrospinal fluid, early repeated imaging is urgently needed and empiric antibiotic therapy should consider anaerobic and aerobic bacteria in these situations.
Highlights
Streptococcal Species is an increasingly recognized intracranial infectious pathogen
Streptococcus constellatus has been described as the fourth common clinical cause (Chang et al 2002).There were increasing reports of brain infection caused by anaerobic bacteria, such as Prevotella oris and Peptostreptococcus micros (Frat et al 2004), Parvimonasmicra (Ko et al 2015), Peptoniphilus asaccharolyticus (Okui et al 2016) and Polymicrobial anaerobic(Llitjos et al 2016), anaerobic culture of cerebrospinal fluid (CSF) was not recommended(Baron et al 2013)
There have not been any cases about cerebral infarction accompanied by intracranial mixed infection caused by Prevotella intermedia and Streptococcus constellatus in China
Summary
Streptococcal Species is an increasingly recognized intracranial infectious pathogen. Cranial CT showed the left frontal lesions with unknown cause The patient’s parents, siblings, and children were all physically fit, but the patient had been smoking and drinking for many years and had a history of alcoholic liver. On examination, he was confused and disorientated with a temperature at 40 °C. The cranial magnetic resonance venography (MRV) images showed abnormality in straight sinuses and superior sagittal sinus (Fig. 1g). The CT scan of head was taken immediately (Fig. 2) It showed that the patient had cerebral hernia and should receive craniotomy and decompressive craniectomy.
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