Purulent Proctitis Caused by Prevotella bivia in a Homosexual Male

Abstract

A 32-year-old homosexual male presented with suprapubic pain. Computed tomography showed rectal wall thickening. Flexible sigmoidoscopy showed small pockets of pus that were opened with mucosal biopsies, and additional pus was diffusely expressed from the rectal wall by applying blunt pressure with the biopsy forceps. Cultures from the pus grew Prevotella bivia. Symptoms resolved after treatment with doxycycline and metronidazole. Proctitis due to P. bivia was not previously reported.

Scrotal Abscess in a Japanese Patient Caused by Prevotella bivia and Streptococcus agalactiae, Successfully Treated with Cefazolin and Amoxicillin: A Case Report

“…Table 2 summarizes previous reports of Prevotella bivia infections as published in PubMed. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Similar to our case, the case presented by Bekasiak et al involved a scrotal abscess and co-infection with a second bacterial genus. 11 Additionally, co-infection occurred in 7 cases, including 2 cases with Prevotella bivia and Streptococcus anginosus, a well-known species that produces an abscess.…”

“…5 Prevotella bivia infections in humans are rare, with only 18 published cases in 44 years. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Since most Prevotella bivia strains are β-lactamase-positive, 24 clindamycin, amoxicillin/clavulanate, metronidazole, and imipenem are the recommended antibacterial agents. 21,25 However, antibiotic resistance varies across countries, 26 and it is unknown whether Prevotella bivia strains in Japan are β-lactamase positive.…”

A Rare Paronychia with Superinfection with Prevotella bivia and Staphylococcus haemolyticus: The Importance of Early Microbiological Diagnosis

“…Its growth and pathogenicity are favored by an excess of estrogens or the synergistic cooperation of other aerobic microorganisms. PB thrives in the vaginal tract, and is associated with bacterial vaginosis, pelvic inflammation disease and perianal abscesses [10][11][12]. PB has been isolated together with aerobic organisms in mixed infections on nails, oral cavity, face and neck [6,[13][14][15].Many authors report that mixed infections where PB participates can induce severe complications such as necrotizing fasciitis, osteomyelitis or septic arthritis, even more if therapeutic management is poor [7,[16][17][18][19].…”