Bittar Julie M, Gazzetta Joshua
Indiana University School of Medicine, Indianapolis, IN, United States.
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States.
Respir Med Case Rep. 2019 Jul 25;28:100916. doi: 10.1016/j.rmcr.2019.100916. eCollection 2019.
Gardnerella vaginalis is an anaerobic, gram-variable bacterium primarily found in vaginal microflora of women. Previous reports of G. vaginalis cultured in men are few and have primarily been limited to the gastrointestinal and genitourinary tract. Few reports of G. vaginalis causing severe infections have been reported in the literature, including septicemia and two cases of perinephric abscess. There has been one previously reported case of G. vaginalis causing pulmonary complications that occurred in a male alcohol abuser. In our case review, we aim to demonstrate an unusual source of a pulmonary infection and highlight the importance of proper microbial isolation to guide treatment. Our patient is a young male who presented following multiple gunshot wounds including one to his head causing an intracranial hemorrhage, hydrocephalus, and a dural sinus thrombosis. His hospital course was complicated by a decline in neurological status treated with a craniotomy and external drain placement and multiple pulmonary infections. During his fever work-ups, he found to have G. vaginalis on mini-bronchoalveolar lavage and was subsequently treated with metronidazole. After treating his G. vaginalis pneumonia and other infectious sources, namely Haemaphilus influenzae and coagulase-negative staphylococcus pneumonias, his fevers and leukocytosis resolved and he was successfully discharged to a rehabilitation facility for neurologic recovery. To our knowledge, this is the second reported case of G. vaginalis isolated from a pulmonary culture and the first in a previously healthy, immunocompetent young male outside of the urinary tract.
阴道加德纳菌是一种厌氧菌，革兰氏染色可变，主要存在于女性阴道微生物群中。此前关于男性培养出阴道加德纳菌的报道很少，主要局限于胃肠道和泌尿生殖道。文献中很少有关于阴道加德纳菌引起严重感染的报道，包括败血症和两例肾周脓肿。此前有一例阴道加德纳菌导致肺部并发症的报道，发生在一名男性酗酒者身上。在我们的病例回顾中，我们旨在展示一种不寻常的肺部感染来源，并强调正确的微生物分离对指导治疗的重要性。我们的患者是一名年轻男性，因多处枪伤入院，其中一处头部枪伤导致颅内出血、脑积水和硬脑膜窦血栓形成。他的住院过程因神经功能状态下降而复杂化，接受了开颅手术和外置引流管置入治疗，还发生了多次肺部感染。在他发热检查期间，经小型支气管肺泡灌洗发现他感染了阴道加德纳菌，随后接受了甲硝唑治疗。在治疗他的阴道加德纳菌肺炎和其他感染源，即流感嗜血杆菌和凝固酶阴性葡萄球菌肺炎后，他的发热和白细胞增多症得到缓解，随后成功出院，前往康复机构进行神经功能恢复。据我们所知，这是第二例从肺部培养物中分离出阴道加德纳菌的报道病例，也是第一例在尿路以外的先前健康、免疫功能正常的年轻男性中出现的病例。
