Neisseria Cinerea Bacteremia Secondary to a Retropharyngeal Abscess

Kaitlin Mcdade,Colin De La Houssaye,Mary Bavaro,David Pash,Abhinav Singla

doi:10.7759/cureus.14217

Abstract

Neisseria cinerea is a commensal bacteria of the human oropharynx, not thought to be pathogenic, and is rarely associated with serious infections, including bacteremia. Case reports involving invasive N. cinerea infections are uncommon in the literature. Retropharyngeal abscesses are unusual in adults, and are usually attributable to local trauma.Based on a review of the literature, Neisseria cinerea bacteremia secondary to a retropharyngeal abscess has not been described. We present a unique case of an elderly female without clear predisposing factors for a retropharyngeal abscess, who presented with a N. cinerea bacteremia and was found to have an asymptomatic retropharyngeal abscess.

Highlights

Neisseria cinerea is a commensal bacteria of the human oropharynx, with low pathogenic potential, and very few reported cases of bacteremia [1]
We present a unique case of an elderly female without predisposing factors, who presented with fever and confusion, but lacked typical symptoms of a retropharyngeal abscess, which is suspected to be the source for her N. cinerea bacteremia
While N. cinerea can be a commensal bacteria of the human oropharynx, with low pathogenic potential, it is on occasion pathogenic, as was seen in this case

Summary

Introduction

Neisseria cinerea is a commensal bacteria of the human oropharynx, with low pathogenic potential, and very few reported cases of bacteremia [1]. Physical examination was significant for mild diffuse abdominal tenderness to palpation and mild confusion She was started on norepinephrine in the emergency department, as well as piperacillin-tazobactam and azithromycin for suspected pneumonia. On hospital day 4, due to unclear source of infection and ongoing neck pain, an MRI of the head and neck was obtained This demonstrated a 7 mm abnormal fluid collection in the retropharyngeal space with surrounding soft tissue edema (Figure 1). She was discharged on hospital day 6, with a treatment plan to continue oral metronidazole 500 mg three times daily and ceftriaxone 2 g daily pending further follow-up in the Infectious Diseases clinic with serial imaging to document resolution of the abscess

Discussion

Conclusions

Disclosures

Tannebaum RD