Abstract
Background Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare. We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 71-year-old male.Case presentationWe describe a 71-year-old man who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of 2 weeks duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms. The diagnosis required 16S rDNA sequencing analysis of the cultured isolate from CSF. Literature review of M. hominis CNS infections yielded 19 cases (13 instances of brain abscess, 3 of meningitis, 1 spinal cord abscess and 1 subdural empyema each). Delay in diagnosis and initial treatment failure was evident in all cases. With appropriate microbiological testing, antibiotic therapy (ranging from 5 days to 12 weeks) and often, multiple surgical interventions, almost all the patients improved immediately.ConclusionsBoth our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries laboratories with limited diagnostic resources.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1885-4) contains supplementary material, which is available to authorized users.
Highlights
ConclusionsBoth our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries laboratories with limited diagnostic resources
Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; central nervous system (CNS) infections are rare
Both our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries laboratories with limited diagnostic resources
Summary
The prevalence of brain infections caused by M. hominis may be increasing, presenting a diagnostic and therapeutic challenge to clinicians. We reported here the first case of meningitis caused by M. hominis in an adult in China, who was successfully treated with azithromycin and minocycline. The pathogenic potential of M. hominis, the need for early diagnosis, and the importance of initial appropriate chemotherapy must be highlighted in developing countries, where the challenges in diagnostic capacity for clinical laboratories are greater. Additional file 1: Near complete length GenBank Mycoplasma hominis 16S rRNA sequences analysis. A summary of all the Mycoplasma hominis16S rRNA sequences deposited in GeneBank.
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