Blood Culture-Negative Infective Endocarditis by Mycoplasma hominis: Case Report and Literature Review

Bustos-Merlo, Antonio; Rosales-Castillo, Antonio; Cobo, Fernando; Hidalgo‐Tenorio, Carmen

doi:10.3390/jcm11133841

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…should be considered. The positive blood culture bottles in this case were all anaerobic bottles, which was consistent with other reported cases [15]. We speculated that the addition of polyaniline sulfonate and anticoagulant in the aerobic bottle may inhibit the growth of Mycoplasma.…”

Section: Discussionsupporting

confidence: 90%

Application of Next-Generation Sequencing on Diagnosis of Bloodstream Infection Caused by Mycoplasma hominis in a Patient With ANCA-Associated Vasculitis

Chen

Huang

et al. 2022

Preprint

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Background: Mycoplasma hominis is one of the main opportunistic pathogenic Mycoplasma in human which has a major impact on patients with bloodstream infections. Because it is difficult to detect or isolate, the rapid and accurate diagnosis is essential and still challenging for patients with bloodstream infection. Case presentation: In this case, we reported the application of next -generation sequencing on diagnosis of bloodstream infection caused by Mycoplasma hominis in a patient with ANCA-associated vasculitis. After 9 days of combined treatment with levofloxacin, polymyxin B, and meropenem, the patient’s infected situation was gradually controlled and he was discharged without further complications. During the three-month outpatient follow-up, no recurrence of symptoms or signs was reported. Conclusions: This successful application of the next generation sequencing assisted the rapid diagnosis of Mycoplasma hominis bloodstream infection, provided a new perspective in the clinical approach and highlighted the potential of this technique in rapid etiological diagnosis.

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Section: Discussionsupporting

confidence: 90%

Application of Next-Generation Sequencing on Diagnosis of Bloodstream Infection Caused by Mycoplasma hominis in a Patient With ANCA-Associated Vasculitis

Chen

Huang

et al. 2022

Preprint

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“…The first patient was a girl in her early childhood with a congenital heart malformation requiring biventricular repair who developed a right atrial and perivalvular abscess and died 5. The second patient was a man in his 60s who had an implantable cardioverter defibrillator (ICD) inserted following sustained monomorphic ventricular tachycardia secondary to structural heart disease 6. He developed M. hominis endocarditis requiring explantation of the ICD and improved clinically with moxifloxacin and doxycycline.…”

Section: Discussionmentioning

confidence: 99%

“…Doxycycline is the antibiotic of choice for M. hominis endocarditis, with a recommended duration of treatment generally between 6 and 8 weeks 6. Most case reports document a combination antibiotic regimen of doxycycline with either clindamycin or quinolone.…”

Section: Discussionmentioning

confidence: 99%

A subacute presentation ofMycoplasma hominisprosthetic valve endocarditis

2022

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Mycoplasma hominisis a rare but important cause of prosthetic valve endocarditis. It is usually associated with acute progression of symptoms and can be difficult to diagnose as it does not grow in standard culture media. We report a case of an immunocompetent man in his 70s who presented with 14-month subacute decline with shortness of breath and evidence of a splenic infarct. Following a redo aortic valve replacement and diagnosis ofM. hoministhrough 16S ribosomal ribonucleic acid PCR, he improved clinically with oral doxycycline therapy. He remained well at follow-up 2 years post-cessation of antibiotics. We present a literature review highlighting the role of PCR testing in the microbiological identification ofM. hominis.

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“…These infections particularly occur during the peripartum period and might be associated with potential adverse neonatal outcomes such as bronchopulmonary dysplasia ( 3 , 4 ). Extra-genitourinary infections are relatively rare but have also been documented, including mediastinitis ( 2 , 5 - 8 ), wound infections ( 1 , 9 ), arthritis ( 10 - 14 ), meningitis ( 4 , 15 - 18 ), endocarditis ( 19 - 21 ), and abscess ( 22 , 23 ), a large portion of which are postoperative infection. Among them, M. hominis mediastinitis especially tends to be severe with high mortality.…”

Section: Introductionmentioning

confidence: 99%

Accurate etiological diagnosis of Mycoplasma hominis mediastinitis in immunocompetent patients using metagenomic next-generation sequencing: a case series and literature review

Cai,

Pan,

Wang

et al. 2024

J Thorac Dis

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Background As a culture-independent method, metagenomic next-generation sequencing (mNGS) is widely used in microbiological diagnosis with advantages in identifying potential pathogens, guiding antibiotic therapy, and improving clinical prognosis, especially in culture-negative cases. Mycoplasma hominis ( M. hominis ) mediastinitis is a rare and severe disease for which etiological diagnosis is important but challenging. The application of mNGS in the etiological diagnosis of mediastinitis has seldom been studied. Methods By searching the electronic medical history retrieval system with “ Mycoplasma hominis ” and “mediastinitis”, seven patients diagnosed with M. hominis mediastinitis were reviewed in Zhongshan Hospital, Fudan University, Shanghai from 9 December 2020 to 14 February 2023. Microbiological cultures and mNGS were conducted for blood, abscess, and/or mediastinal fluid. Adjustment of the antibiotic therapy due to mNGS was assessed. A literature review was conducted in the PubMed database beginning in 1970 for M. hominis infection and mediastinitis. Results For the seven patients, cultures of blood, abscess, and mediastinal fluid were negative whereas mNGS identified M. hominis in serum, abscess, and/or mediastinal fluid and was used to guide specific antibiotic therapy. The stringent mapped reads number of genera (SMRNG), stringent mapped reads number of species (SMRN), and coverage rate of M. hominis detection by mNGS were significantly higher in body fluid (abscess or mediastinal fluid) than in serum. All seven patients had underlying heart diseases and underwent previous cardiac surgery. The most common symptoms were fever and sternal pain. After detection of M. hominis , antibiotics were adjusted to quinolones or doxycycline except for one patient, whose diagnosis was clarified after death. Two patients died. Literature review since 1970 identified 30 cases of extra-genital infection caused by M. hominis . Including our seven new cases, 2 (5.4%) were neonates and 35 (94.6%) were adults. Thirty (81.1%) cases were postoperative infection and 15 (40.5%) had implanted devices. Five patients (13.5%) died. Conclusions mNGS might be a promising technology in the detection of fastidious pathogens such as M. hominis . Accurate etiological diagnosis by mNGS could guide antibiotic therapy and facilitate clinical management.

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Blood Culture-Negative Infective Endocarditis by Mycoplasma hominis: Case Report and Literature Review

Cited by 5 publications

References 28 publications

Application of Next-Generation Sequencing on Diagnosis of Bloodstream Infection Caused by Mycoplasma hominis in a Patient With ANCA-Associated Vasculitis

Application of Next-Generation Sequencing on Diagnosis of Bloodstream Infection Caused by Mycoplasma hominis in a Patient With ANCA-Associated Vasculitis

A subacute presentation ofMycoplasma hominisprosthetic valve endocarditis

Accurate etiological diagnosis of Mycoplasma hominis mediastinitis in immunocompetent patients using metagenomic next-generation sequencing: a case series and literature review

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