Autoinfection as a cause of postpartum subdural empyema due to Mycoplasma hominis

Infection. 2015 Apr;43(2):241-4. doi: 10.1007/s15010-014-0713-2. Epub 2014 Dec 10.

Abstract

Mycoplasma hominis is a commensal of the genitourinary tract, which is infrequently associated with urogenital infections. Extra-urogenital infections due to M. hominis are rare. Here, we report an unusual case of M. hominis subdural empyema in a woman occurring shortly after delivery. The patient presented with symptoms suggestive of bacterial meningitis. Spinal imaging revealed a subdural empyema that required neurosurgical intervention. Cultures from intraoperatively obtained biopsies identified M. hominis as the causative pathogen. The patient was treated with oral moxifloxacin for 4 weeks resulting in the resolution of the spinal lesion. The subdural empyema was presumably caused by a contaminated epidural blood patch performed with the patient's own blood during an episode of transient M. hominis bacteremia after delivery. The blood patch was indicated for the treatment of cerebrospinal fluid leakage, which had occurred after epidural anesthesia. Our findings highlight the significance of transient M. hominis bacteremia after delivery and implicate that M. hominis should be considered as a causative agent of extra-genitourinary tract infections particularly during the postpartum period or after genitourinary manipulation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Empyema, Subdural / diagnosis*
  • Empyema, Subdural / microbiology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Mycoplasma Infections / diagnosis*
  • Mycoplasma Infections / microbiology*
  • Mycoplasma hominis*
  • Postpartum Period*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents