Dialister pneumosintes and aortic graft infection – a case report

Abstract

Background Dialister pneumosintes is an anaerobic, Gram negative bacillus, found in the human oral cavity and associated with periodontitis. It has also been isolated from gastric mucosa and stool samples. Recent case reports implicate D. pneumosintes in local infection such as dental root canals, sinusitis, Lemierres syndrome and brain abscesses, as well as distal infections of the liver and lung through haematogenous spread. Case presentation We present a novel case of aortic graft infection and aortoenteric fistula (AEF) in a 75 year old Caucasian male, associated with D. pneumosintes bacteraemia. Microbiological evaluation of septic emboli in the lower limbs revealed other gastrointestinal flora. This suggests either AEF leading to graft infection and subsequent distal emboli and bacteraemia, or a dental origin of infection which seeded to the graft, resulting in AEF and systemic infection. To our knowledge this is the first report of D. pneumosintes associated aortic graft infection. The patient underwent surgical explantation, oversew of the aorta and placement of extra-anatomical bypass graft in conjunction with antimicrobial therapy, making a good recovery with discharge home after a 35-day hospital admission. Conclusion We report a case of Dialister pneumosintes bacteraemia associated with aortic graft infection. To our knowledge, vascular graft-associated infection with D. pneumosintes has not been reported before.

A case of bacteremia caused by Dialister micraerophilus with Enterocloster clostridioformis and Eggerthella lenta in a patient with pyometra

“…The D. micraerophilus isolate in this case was identified by 16S rRNA gene sequencing and MALDI-TOF MS, as previously reported [ 16 ]; 16S rRNA gene sequencing [ 5 , 7 , 8 , 10 , 19 , 20 ] and MALDI-TOF MS [ 6 , 21 ] have also been used to identify D. pneumosintes .…”

“…No reported cases of bacteremia caused by D. micraerophilus exist in the available literature of case reports on bacteremia caused by Dialister spp. (Table 2 ), [ 5 – 8 , 10 , 19 , 20 , 21 ]. Although bacteremia caused by D. pneumosintes is mainly associated with dental infections or sinusitis [ 5 – 8 , 19 , 20 , 21 ], a case of D. pneumosintes bacteremia associated with vaginosis has been reported [ 10 ], and D. pneumosintes has also been isolated from gynecological samples [ 1 ].…”