A.O. Ospedali Riuniti "Villa Sofia-Cervello", Palermo, Italy.
A.O.U. Paolo Giaccone, Palermo, Italy.
New Microbiol. 2023 May;46(2):216-218.
We report a case of a 26-year-old female who developed a brain abscess that was strongly suspected to be caused by Staphylococcus epidermidis, A. aphrophilus, and E. corrodens species. In general, A. aphrophilus and E. corrodens, members of the HACEK group (Haemophilus spp., Aggregatibacter spp., C. hominis, E. corrodens, and K. kingae), have been associated with the development of endocarditis, meningitis, sinusitis, otitis media, pneumonia, osteomyelitis, peritonitis, and wound infections. Cerebral abscesses are a rare manifestation of these bacteria; only a few cases are described in the literature, generally related to the diffusion of these organisms through the bloodstream after a dental procedure or a heart disease. Our case is unique because the rarity of the infection site appeared apparently in absence of risk factors. The patient underwent surgery to drain the abscess and was subsequently put on intravenous antibiotic treatment with ceftriaxone, vancomycin, and metronidazole. After 6 months, brain imaging revealed that the lesion had disappeared. The patient achieved excellent results with this approach.
我们报告了一例 26 岁女性患者，她患有脑脓肿，强烈怀疑是由表皮葡萄球菌、嗜沫阿克曼菌和侵蚀艾肯菌引起的。一般来说，嗜血杆菌属（Haemophilus spp.）、聚集艾肯菌属（Aggregatibacter spp.）、人解脲支原体（C. hominis）、侵蚀艾肯菌（E. corrodens）和金氏金杆菌（K. kingae）属于 HACEK 组，它们与心内膜炎、脑膜炎、鼻窦炎、中耳炎、肺炎、骨髓炎、腹膜炎和伤口感染的发展有关。脑脓肿是这些细菌的罕见表现形式；文献中仅描述了少数几例，一般与这些生物体通过血液扩散有关，如在牙科手术后或心脏病发生后。我们的病例是独特的，因为感染部位的罕见性似乎出现在没有危险因素的情况下。患者接受了脓肿引流手术，随后接受了头孢曲松、万古霉素和甲硝唑的静脉抗生素治疗。6 个月后，脑部成像显示病变已消失。患者通过这种方法取得了极佳的效果。
