title: Postoperative Mycoplasma hominis brain abscess: keep it in mind!
abstract: A temporal lobe abscess was diagnosed in a 57-year-old man. A urethral catheter had been inserted 12 days earlier, just prior to clot evacuation of a subacute haematoma secondary to an arterio-venous malformation. Fever persisted despite debridement and treatment with meropenem and vancomycin. Gram stains of operative samples showed no bacteria. Extended cultures grew pinpoint colonies after 5 days. Meanwhile, sequencing of bacterial 16S rDNA from operative specimens had identified Mycoplasma hominis; the bacterial colonies were subsequently similarly identified. The patient responded promptly following addition of oral doxycycline 100 mg two times per day. There is a growing literature of similar cases. Transient bacteraemia, following urinary catheterisation, with seeding of existing sites of inflammation is the proposed explanation. Urethral carriage of M. hominis is 15% and catheterisation is a common procedure. Mycoplasma hominis maybe more common than appreciated, especially as the need for extended cultures makes a correct diagnosis less likely.
authors.affiliation: Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Sarah Maria
authors.identifier: http://orcid.org/0000-0002-8766-5042
authors.initials: SM
authors.lastname: Bergin
authors.affiliation: Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Shehara M
authors.initials: SM
authors.lastname: Mendis
authors.affiliation: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Young
authors.affiliation: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Ezlyn
authors.initials: E
authors.lastname: Binti Izharuddin
mesh_terms: D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D004269:DNA, Bacterial / Q000302:isolation & purification; D020199:Hematoma, Subdural, Acute / Q000601:surgery; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009175:Mycoplasma Infections / Q000175:diagnosis*; D019535:Mycoplasma hominis / Q000235:genetics; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014521:Urethra; D014546:Urinary Catheterization / Q000009:adverse effects*
chemical_list: D004269:DNA, Bacterial