Unusual manifestation of Helicobacter cinaedi infection: a case report of intracranial subdural empyema and bacteremia

Abstract

BackgroundThere have been various reports concerning Helicobacter cinaedi infections. However, few reports have examined central nervous system infections.Case presentationA 52-year-old man was transferred from the local hospital because of a persistent headache and suspected intracranial subdural empyema. Neurosurgical drainage was performed via burr holes. Gram staining and results from abscess cultures were negative. The blood culture yielded H. cinaedi. He was given an antibiotic regimen consisting of 2 g of ceftriaxone twice a day, but the size of the abscess was not reduced in size at all after 3 weeks of treatment. Neurosurgical drainage was performed again, and the antimicrobial regimen was switched to 2 g of meropenem 3 times a day. The size of the abscess was reduced after 2 weeks of the second drainage and antimicrobial drug change to meropenem. After 4 weeks treatment with meropenem, the patient was discharged, and his symptoms had completely resolved.Conclusions H. cinaedi infection should be considered in the differential diagnosis of subdural empyema cases for which Gram staining and abscess culture results are negative. Meropenem can be a first-line drug of choice or an effective alternative treatment for H. cinaedi central nervous system infections.

A Case Of Recurrent Helicobacter cinaedi Prosthetic Joint Infection In An HIV-Infected Man

“… 1 . For some authors, meropenem is considered the first-line drug, especially for the treatment of severe infections 4 . We treated our patient with initial high-dose intravenous meropenem followed by oral minocycline, for a total of 12 weeks.…”

“…Since then, various clinical presentations, e.g. sepsis, recurrent bacteremia 2 , cellulitis 3 , endocarditis, central nervous system infections 4 , or osteoarticular infections 5 , 6 , have been reported. Implant-associated infections have not yet been described.…”

Other Helicobacters, gastric and gut microbiota

“…A 40‐year‐old woman with systemic lupus erythematosus presented with high‐grade fever and severe thrombocytopenia, suggesting a complication of her disease, and she was finally diagnosed with H. cinaedi bacteremia . In another case report, a 52‐year‐old Japanese man with a persistent headache and suspected intracranial subdural empyema was diagnosed with H. cinaedi bacteremia treated by two neurosurgical drainages and 4 weeks of meropenem 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.…”

“…Also in this study, no clear correlation was found between infection and gastritis, although gastric carcinoma was observed in a cat infected with H. heilmannii s.s. 9 Although it should be noted that the authors did not test for all carnivore Helicobacter species, Hong et al 10 17 In another case report, a 52-year-old Japanese man with a persistent headache and suspected intracranial subdural empyema was diagnosed with H. cinaedi bacteremia treated by two neurosurgical drainages and 4 weeks of meropenem treatment. 18 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.…”

Genomic and Histological Analysis of Helicobacter Himalayensis Sp. Nov. Isolated From Marmota Himalayana to Discovery the Potential Human Pathogen

“…However, studies of the association between diseases and non-H. pylori species are lacking. There are only a few reports about non-H. pylori infection in humans, mostly in immunocompromised patients (14)(15)(16)(17). Thus, the pathogenicity and genetic characteristics of non-H. pylori remain to be explored.…”