Mycobacterium tuberculosis and Pseudoramibacter alactolyticus coinfection in brain after dental extraction: A case report

Medicine (Baltimore). 2019 Dec;98(50):e18289. doi: 10.1097/MD.0000000000018289.

Abstract

Introduction: More than 1200 different types of microbes were found in the human mouth, only some of these microorganisms were associated with intracranial bacterial infection. However, there are limited data available about the Pseudoramibacter alactolyticus (P alactolyticus) or Mycobacterium tuberculosis (MTB) intracranial infections oral origin.

Patient concerns: Here, we reported a rarely case with P alactolyticus and MTB coinfection in central nervous after dental extraction. The 44-year-old man presented with progressive headache over the last 2 weeks and a sustained fever >39°C, with a dental extraction performed 2 days before the onset of headache.

Diagnosis: P alactolyticus and MTB were confirmed by real-time polymerase chain reaction targeting the16S ribosomal RNA gene. The presence of MTB was also demonstrated by positive acid-fast staining of the purulent discharge.

Interventions: The patient was treated by metronidazole and anti-TB treatment OUTCOMES:: The patient fully recovered without sequela.

Conclusion: In conclusion there should be awareness of the possibility of P alactolyticus or MTB intracranial infections following tooth extraction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Clostridiales / genetics
  • Clostridiales / isolation & purification*
  • Coinfection / drug therapy
  • Coinfection / etiology*
  • Coinfection / microbiology
  • Humans
  • Infectious Encephalitis / drug therapy
  • Infectious Encephalitis / ethnology*
  • Infectious Encephalitis / microbiology
  • Magnetic Resonance Imaging
  • Male
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification*
  • RNA, Bacterial / analysis
  • Tooth Extraction / adverse effects*
  • Tuberculosis, Central Nervous System / drug therapy
  • Tuberculosis, Central Nervous System / etiology*
  • Tuberculosis, Central Nervous System / microbiology

Substances

  • Anti-Bacterial Agents
  • RNA, Bacterial

Supplementary concepts

  • Pseudoramibacter alactolyticus