Zhou Menglan, Wang Peng, Chen Sharon, Du Bin, Du Jinlong, Wang Fengdan, Xiao Meng, Kong Fanrong, Xu Yingchun
Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
BMC Infect Dis. 2016 Oct 12;16(1):557. doi: 10.1186/s12879-016-1885-4.
Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare. We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 71-year-old male.
We describe a 71-year-old man who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of 2 weeks duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms. The diagnosis required 16S rDNA sequencing analysis of the cultured isolate from CSF. Literature review of M. hominis CNS infections yielded 19 cases (13 instances of brain abscess, 3 of meningitis, 1 spinal cord abscess and 1 subdural empyema each). Delay in diagnosis and initial treatment failure was evident in all cases. With appropriate microbiological testing, antibiotic therapy (ranging from 5 days to 12 weeks) and often, multiple surgical interventions, almost all the patients improved immediately.
Both our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries laboratories with limited diagnostic resources.
人型支原体是新生儿感染的常见病因，也有报道称其为成人泌尿生殖系统感染的病原体；然而，中枢神经系统（CNS）感染较为罕见。我们在此报告中国首例人型支原体脑膜炎病例，该病例为一名71岁男性，在接受脑出血神经外科治疗后发病。
我们描述了一名71岁男性，在接受神经外科治疗后发生人型支原体脑膜炎，尽管因脑脊液（CSF）革兰氏染色未发现可见微生物而延误治疗，但经为期2周的阿奇霉素和米诺环素联合治疗后成功治愈。诊断需要对脑脊液培养分离株进行16S rDNA测序分析。对人型支原体中枢神经系统感染的文献回顾发现了19例病例（脑脓肿13例、脑膜炎3例、脊髓脓肿1例和硬膜下积脓各1例）。所有病例均存在诊断延误和初始治疗失败的情况。通过适当的微生物检测、抗生素治疗（疗程从5天到12周不等），且通常需要多次手术干预，几乎所有患者都立即好转。
我们的患者病例以及文献回顾均强调了人型支原体的致病潜力，以及罕见传染病带来的挑战，特别是对于诊断资源有限的发展中国家实验室而言。
