First Case of Intracranial Mycotic Aneurysm Caused by &lt;b&gt;&lt;i&gt;Prevotella intermedia&lt;/i&gt;&lt;/b&gt; Associated with Chronic Sinusitis in a Korean Adult

Park, Hea Ree; Chang, Jae Suk; Kim, Sollip; Um, Tae Hyun; Cho, Chong Rae

doi:10.1159/000506764

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Regarding ischemic stroke, the genus Prevotella was found to be enriched in the patient group with poor treatment outcome [ 228 ]. DNA of P. intermedia has been recovered from ruptured intracranial aneurysm walls [ 229 ] and in culture of cerebrospinal fluid from a patient of intracranial mycotic aneurysm [ 230 ]. A metronidazole-resistant P. loescheii strain has been isolated from subdural hematoma [ 231 ].…”

Section: Potential Involvement Of Oral Prevotella ...mentioning

confidence: 99%

Prevotella species as oral residents and infectious agents with potential impact on systemic conditions

Könönen

Fteita

Gürsoy

et al. 2022

Journal of Oral Microbiology

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Oral Prevotella are known as anaerobic commensals on oral mucosae and in dental plaques from early life onwards, including pigmented P. melaninogenica, P. nigrescens, and P. pallens and non-pigmented Prevotella species. Many Prevotella species contribute to oral inflammatory processes, being frequent findings in dysbiotic biofilms of periodontal diseases ( P. intermedia, P. nigrescens ), cariotic lesions ( P. denticola, Alloprevotella (formerly Prevotella ) tannerae ), endodontic infections ( P. baroniae, P. oris, P. multisaccharivorax ), and other clinically relevant oral conditions. Over the years, several novel species have been recovered from the oral cavity without knowledge of their clinical relevance. Within this wide genus, virulence properties and other characteristics like biofilm formation seemingly vary in a species- and strain-dependent manner, as shown for the P. intermedia group organisms ( P. aurantiaca, P. intermedia, P. nigrescens , and P. pallens ). Oral Prevotella species are identified in various non-oral infections and chronic pathological conditions. Here, we have updated the knowledge of the genus Prevotella and the role of Prevotella species as residents and infectious agents of the oral cavity, as well as their detection in non-oral infections, but also gathered information on their potential link to cancers of the head and neck, and other systemic disorders.

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Section: Potential Involvement Of Oral Prevotella ...mentioning

confidence: 99%

Prevotella species as oral residents and infectious agents with potential impact on systemic conditions

Könönen

Fteita

Gürsoy

et al. 2022

Journal of Oral Microbiology

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“…Regarding ischemic stroke, Prevotella intermedia has been proven to be enriched in patients with poor treatment outcome [ 13 ]. It has also been cultured in the cerebrospinal fluid of a patient with intracranial mycotic aneurysm [ 14 ]. Prevotella intermedia meningitis has been associated with cerebrospinal fluid leakage in an adolescent, with the suggestion that its route of extension could be through retrograde influx from the oropharynx into the cerebrospinal space [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Ye,

He,

et al. 2023

BMC Neurol

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Background Isolated Prevotella intermedia, a rare gram-negative, rod-shaped, anaerobic bacterium, is rarely detected in clinical practice. It has been associated with infections of the oral cavity and female genital tract, but has never been detected in cerebrospinal fluid (CSF) of patients in China. Accurate detection of causative pathogens is still an arduous task owing to the difficult conditions of anaerobic bacterial culture. Isolated Prevotella intermedia can be detected by metagenomic next generation sequencing (mNGS) of the CSF. Correct diagnosis and antibiotic treatment can help patients avoid life-threatening events. Case presentation Herein, we describe the case of a 64-year-old Chinese woman who presented with typical features of meningoencephalitis. Routine CSF culture failed to identify the causative pathogen. Isolated Prevotella intermedia was detected by mNGS, and the patient was treated with antibacterial agents including ceftriaxone, vancomycin, moxifloxacin, meropenem, metronidazole, and linezolid. The patient underwent surgical treatment for abscess of left frontal parietal lobe, which was observed on magnetic resonance imaging (MRI) and was suspected to be caused by Prevotella intermedia. It was further confirmed that it was a secondary infection from the oral cavity, and the possible etiology might have been dental surgery. Treatment was rendered to the patient based on metagenomic test result, and her condition improved after two months. Conclusions This case highlights the role of mNGS in accurate diagnosis of patients with central nervous system infection. In particular, mNGS can be used to identify rare pathogens and confirm the diagnosis in patients with unknown etiology.

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“…At present, only two cases were reported. Park et al (9) reported a case of intracranial mycotic aneurysm caused by P. intermedia associated with chronic sinusitis and successfully identified the bacteria by 16S rRNA sequencing. In Kyoya's case (30), a 62-year-old man displayed multiple infectious intracranial aneurysms, intracerebral hemorrhage, and epistaxis after tooth extraction.…”

Section: Discussionmentioning

confidence: 99%

“…Prevotella is the second most abundant genus. Several studies have reported that Prevotella was associated with meningitis and was involved in the formation of brain abscesses (3,5,9). In Mo's case, a 48year-old man, with mixed infections caused by P. intermedia and S. constellatus, presented a large area of ischemic infarction and ultimately abandoned the treatment due to a worsening condition (36).…”

Section: Discussionmentioning

confidence: 99%

Case report: Meningitis and intracranial aneurysm caused by mixed infection of oral microflora dominated by anaerobes

Cheng

Yang

et al. 2022

Front. Neurol.

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IntroductionMeningitis caused by oral anaerobic bacteria is rare, especially when complicated with an infected intracranial aneurysm. This paper has described an extremely rare case of bacterial meningitis caused by a mixed infection of oral microflora dominated by anaerobes, which developed cerebral infarcts, brain abscess, intracranial aneurysm, and severe hydrocephalus during treatment.Case reportWe describe a 65-year-old male patient who was presented with fever and headache as the initial symptoms and then developed left ophthalmoplegia, right hemiplegia, and disturbance of consciousness. Brain imaging showed that intracranial lesions were increased progressively, and cerebral infarcts, brain abscesses, intracranial aneurysm, and severe hydrocephalus were appeared gradually. Eventually, we diagnosed it as anaerobic meningitis by making deoxyribonucleic acid sequencing from the brain abscess pus. After using an anti-microbial regimen that can sufficiently cover anaerobes, the patient's condition was effectively controlled.ConclusionAnaerobic meningitis can cause a series of intracranial complications. Among them, the intracranial aneurysm is extremely rare. When evidence shows that the infection originates from oral flora, physicians should consider the possibility of this type of encephalitis. An early diagnosis and timely treatment are crucial to improving the prognosis.

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First Case of Intracranial Mycotic Aneurysm Caused by <b><i>Prevotella intermedia</i></b> Associated with Chronic Sinusitis in a Korean Adult

Cited by 10 publications

References 13 publications

Prevotella species as oral residents and infectious agents with potential impact on systemic conditions

Prevotella species as oral residents and infectious agents with potential impact on systemic conditions

Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing

Case report: Meningitis and intracranial aneurysm caused by mixed infection of oral microflora dominated by anaerobes

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