The First Case Report of Cerebral Cyst Infection Due to <i>Helicobacter cinaedi</i>

Abstract

SUMMARY:We report the first case of cerebral cyst infection by Helicobacter cinaedi, a fastidious spiral-shaped gram-negative rod bacterium. A 70-year-old man visited Tokyo Medical University Hospital with persisting fever since 2 weeks. He underwent surgery and radiotherapy for parapharyngeal space squamous cell carcinoma 10 years ago. The radiotherapy resulted in a cerebral cyst as a side effect, and an Ommaya reservoir was inserted into the cyst. Blood culture and analysis of the brain cyst fluid revealed the presence of spiral-shaped gram-negative rod bacteria, which were identified as H. cinaedi by polymerase chain reaction. Initially, we administered clarithromycin (400 mg per day). After H. cinaedi infection was confirmed, the treatment was changed to meropenem (MEPM 6 g per day). The patient was treated for 43 days in the hospital with intravenous meropenem, and his clinical course was satisfactory. On the 44th day, he was discharged and prescribed oral minocycline (MINO 200 mg per day). After discharge, the patient's H. cinaedi infection did not recur. Our case illustrated the wide clinical spectrum of H. cinaedi as well as the effectiveness of antibiotic therapy comprising MERM and MINO for treating central nervous system infection by this organism.

Helicobacter cinaedi-infected chronic subdural hematoma mimicking an expanding hematoma: A case report

“…Regarding H. cinaedi central nervous system infections, seven reports have been published, including a case of subdural empyema. [1,7,12,14,15,18,20] To the best of our knowledge, this is the first report of an ISH caused by H. cinaedi.…”

“…Infected subdural hematoma (ISH) caused by hematogenous chronic subdural hematoma (CSDH) infection is a rare clinical entity of intracranial subdural empyema, [4] and few reports are available on Helicobacter cinaedi central nervous system infections. [1,7,12,14,15,18,20] H. cinaedi is an enterohepatic Gram-negative spiral bacillus, and infections with its pathogens have been attracting attention over the past two decades, especially in Japan. [2,10] We present a case of subdural empyema in the preexisting CSDH, mimicking spontaneous hematoma enlargement in the chronic clinical course in an adult.…”

Other Helicobacters, gastric and gut microbiota

“…An Ommaya reservoir was inserted in a cerebral cyst secondary to radiotherapy for parapharyngeal space squamous cell carcinoma 10 years before. 19 Helicobacter cinaedi was also identified in aortic specimen samples from a 49 year-old man with an implantable left ventricular assist device who presented with the complication of a ruptured infective common iliac aneurysm, 20 in another 49 year-old man with multiple myeloma and autologous stem cell transplantation who had febrile diarrhea and malakoplakia, 21 in the urine of a 77 year-old man on hemodialysis admitted for feverishness and penile pain with urination, 22 and in a 38 year-old Japanese man with X-linked agammaglobulinemia complicated by recurrent cellulitis for 2 years. 23 Another patient with agammaglobulinemia had a refractory bacteremia with fever and erythema extended to both legs, caused by H. cinaedi, which was resistant to penicillins and cephalosporins during prolonged treatment.…”

“…The first case of cerebral cyst infection by H. cinaedi was reported in a 70 year‐old man who had a persisting fever for 2 weeks prior to hospital admission. An Ommaya reservoir was inserted in a cerebral cyst secondary to radiotherapy for parapharyngeal space squamous cell carcinoma 10 years before . Helicobacter cinaedi was also identified in aortic specimen samples from a 49 year‐old man with an implantable left ventricular assist device who presented with the complication of a ruptured infective common iliac aneurysm, in another 49 year‐old man with multiple myeloma and autologous stem cell transplantation who had febrile diarrhea and malakoplakia, in the urine of a 77 year‐old man on hemodialysis admitted for feverishness and penile pain with urination, and in a 38 year‐old Japanese man with X‐linked agammaglobulinemia complicated by recurrent cellulitis for 2 years .…”