Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis

Abstract

BackgroundCentral nervous system (CNS) infections caused by Actinomyces spp. including brain abscess, actinomycoma, subdural empyema and epidural abscess are well described, however reports of Actinomyces-associated meningitis are scarcely reported.Case reportWe present the case of a 43-year-old Hungarian male patient with poor socioeconomic status who developed acute bacterial meningitis caused by Actinomyces turicensis originating from the left side mastoiditis. The bacterial cultures of both cerebrospinal fluid (CSF) and purulent discharge collected during the mastoid surgery showed slow growing Gram-positive rods that were identified by automated systems (API, VITEK) as A. turicensis The bacterial identification was confirmed by 16S rRNA PCR and subsequent nucleic acid sequencing. No bacterial growth was detected in blood culture bottles after 5 days of incubation. Hence, multiple antibacterial treatments and surgical intervention the patient passed away.ConclusionsAnaerobes are rarely involved in CNS infections therefore anaerobic culture of CSF samples is routinely not performed. However, anaerobic bacteria should be considered as potential pathogens when certain risk factors are present, such as paranasal sinusitis, mastoiditis in patients with poor socioeconomic condition. To the best of our knowledge, our case report is the first description of A. turicensis meningitis that has been diagnosed as consequence of purulent mastoiditis.

Complete Genome Sequence of Schaalia turicensis Strain CT001, Isolated from a Patient with Gonococcal Urethritis in Thailand

“… Schaalia turicensis is a Gram-positive, filamentous bacillus that is a commensal of the oral cavity, gut, skin, and female urogenital tract ( 1 , 2 ), occasionally causing infections ( 3 ). S. turicensis was inadvertently recovered from a −80°C stock culture (30% glycerol in brain heart infusion broth) from a male patient with gonorrhea at Siriraj Hospital, Thailand, in 2010 after culturing on chocolate agar at 35°C ± 2°C in a 5% CO 2 incubator for 48 h. During PCR screening of the class 1 integron-integrase gene in the Neisseria gonorrhoeae stock culture, only the pinpoint colonies showed positive results.…”

Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases

“…If caught early on and treated appropriately, cervicofacial infections usually resolve without sequelae. However, rare presentations of this disease must also be taken into consideration [20]: in a recent case report from Hungary, A. turicensis was a causative agent of meningitis, following a purulent mastoiditis; unfortunately, the patient died from the complications of this infection [21].…”

Beyond the usual suspects: emerging uropathogens in the microbiome age

“…turicensis is a commensal of the skin, gut, oral cavity, and female urogenital tract (182) but is also an opportunistic pathogen. Clinical isolates have been reported in bacteremia (217), purent mastoiditis and meningitis (218), infection following rotator cuff repair (219), gonococcal urethritis (220), and a perianal abscess (216). The circumstances and conditions that transform S. turicensis from commensal to pathogen remain to be elucidated.…”