Brain Abscess Caused by Ureaplasma urealyticum in an Adult Patient

Abstract

e Ureaplasma urealyticum is a fastidious bacterium usually residing in the female genitourinary tract. We present an exceedingly complicated case of a brain abscess secondary to mastoiditis by U. urealyticum in an adult hypogammaglobulinemic patient after rituximab treatment 3 years earlier. CASE REPORT

A case of Ureaplasma parvum meningitis in an adult after transphenoidal ablation of craniopharyngioma

“…Here, this case should raise alarm about potential consequences of these urogenital commensals as a possible source of post-operative infections. Invasive Ureaplasma infections in adults are often reported in immunocompromised hosts, especially with hypogammaglobulinemia (Arber et al, 2007;Cordtz and Jensen, 2006;Deetjen et al, 2014). Another meningitis due to U. urealyticum has been reported in immunosuppression context, with organ transplantation (Geissdörfer et al, 2008).…”

Ureaplasma urealyticum pyelonephritis presenting with progressive dysuria, renal failure, and neurologic symptoms in an immunocompromised patient

“…Rituximab may increase the risk of Ureaplasma infection by an unknown mechanism, given the five other reports of severe Ureaplasma infection in the context of recent or ongoing rituximab therapy . One hypothesis for the rituximab effect is by reducing immune globulins peripherally.…”

“…Ureaplasma infection in the context of recent or ongoing rituximab therapy. [7][8][9][10][11] One hypothesis for the rituximab effect is by reducing immune globulins peripherally. Indeed, many of these patients with severe U urealyticum infections were hypogammaglobulinemic from rituximab [7][8][9][10][11] or congenital absence of gammaglobulins.…”

“…[7][8][9][10][11] One hypothesis for the rituximab effect is by reducing immune globulins peripherally. Indeed, many of these patients with severe U urealyticum infections were hypogammaglobulinemic from rituximab [7][8][9][10][11] or congenital absence of gammaglobulins. 6,12 Our patient had normal immune globulins measured 3 months prior to her current presentation as did the patient identified in Gerber et al 5 Therefore, further research is necessary to determine the mechanism by which rituximab increases susceptibility to Ureaplasma infection.…”

Severe hematuria in a hematopoietic cell transplant recipient caused by Ureaplasma urealyticum not by BK virus or adenovirus infection

“…However, patients with antibody deficiency such as hypogammaglobulinemia have been found to be more susceptible to U. urealyticum infection and developed several manifestations such as UTI, pneumonitis, septic arthritis, or brain abscess. 5,12 In allogeneic HCT patient, there was a report of polyseptic arthritis by U. urealyticum in high-risk lymphoma patient who received rituximab pretreatment. 13 The prevalence of U. urealyticum in female patients with chronic lower urinary tract symptoms was found to 52.9%.…”