Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

Espinoza‐Gómez, Francisco; Newton-Sánchez, Óscar Alberto; Мельников, В. Л.; Virgen-González, O.; Unrau, Jennifer

doi:10.1590/s1413-86702007000600015

Cited by 11 publications

(9 citation statements)

References 13 publications

(12 reference statements)

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“…in the majority of patients in all the present clinical groups bears close scrutiny as host specific factors might determine whether or not this organism contributes to brain disease. Two HIV/AIDS patients exhibited sequences similar to Alcaligenaceae; members of this family have been identified as components of the normal flora in Peyer’s patches [33], but members have also been implicated in endocarditis [34], bacteremia [35], [36] and meningitis with or without ventriculitis in neonates [37], [38], HIV-infected persons [39], other immunocompromised adults [40] or following invasive surgery [41]. Thus, identifying members of this family may represent translocation of commensal gut organisms to the brain or a previously unidentified subclinical infection in these patients.…”

Section: Discussionmentioning

confidence: 99%

Brain Microbial Populations in HIV/AIDS: α-Proteobacteria Predominate Independent of Host Immune Status

et al. 2013

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The brain is assumed to be a sterile organ in the absence of disease although the impact of immune disruption is uncertain in terms of brain microbial diversity or quantity. To investigate microbial diversity and quantity in the brain, the profile of infectious agents was examined in pathologically normal and abnormal brains from persons with HIV/AIDS [HIV] (n = 12), other disease controls [ODC] (n = 14) and in cerebral surgical resections for epilepsy [SURG] (n = 6). Deep sequencing of cerebral white matter-derived RNA from the HIV (n = 4) and ODC (n = 4) patients and SURG (n = 2) groups revealed bacterially-encoded 16 s RNA sequences in all brain specimens with α-proteobacteria representing over 70% of bacterial sequences while the other 30% of bacterial classes varied widely. Bacterial rRNA was detected in white matter glial cells by in situ hybridization and peptidoglycan immunoreactivity was also localized principally in glia in human brains. Analyses of amplified bacterial 16 s rRNA sequences disclosed that Proteobacteria was the principal bacterial phylum in all human brain samples with similar bacterial rRNA quantities in HIV and ODC groups despite increased host neuroimmune responses in the HIV group. Exogenous viruses including bacteriophage and human herpes viruses-4, -5 and -6 were detected variably in autopsied brains from both clinical groups. Brains from SIV- and SHIV-infected macaques displayed a profile of bacterial phyla also dominated by Proteobacteria but bacterial sequences were not detected in experimentally FIV-infected cat or RAG1−/− mouse brains. Intracerebral implantation of human brain homogenates into RAG1−/− mice revealed a preponderance of α-proteobacteria 16 s RNA sequences in the brains of recipient mice at 7 weeks post-implantation, which was abrogated by prior heat-treatment of the brain homogenate. Thus, α-proteobacteria represented the major bacterial component of the primate brain’s microbiome regardless of underlying immune status, which could be transferred into naïve hosts leading to microbial persistence in the brain.

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Section: Discussionmentioning

confidence: 99%

Brain Microbial Populations in HIV/AIDS: α-Proteobacteria Predominate Independent of Host Immune Status

et al. 2013

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“…However, only a few cases of meningitis (clinical features) related to AX have been published previously [9]. These cases of AX meningitis described in the literature were mainly nosocomial (catheter) [10] or reported in newborns or young children [11–14], immunocompromised subjects [15] or patients with an obvious lesion (extensive burns) [16]. None of these patients was elderly (age >75 years).…”

Section: Discussionmentioning

confidence: 99%

A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma

et al. 2011

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SummaryBackgroundAchromobacter xylosoxidans (AX) is a non-fermentative aerobic Gram-negative bacillus. It is an opportunistic pathogen and the causative agent of various infections. We report an original case of late posttraumatic meningitis due to AX denitrificans.Case ReportAn 83-year-old man was hospitalized for acute headache, nausea and vomiting. The emergency brain computer tomography (CT) scan did not reveal any anomaly. In his medical history, there was an auditory injury due to a cranial trauma incurred in a skiing accident 60 years earlier. Cytobiochemical analysis of the cerebrospinal fluid (CSF) revealed increased levels of neutrophils and proteins. The CSF bacterial culture was positive: the Gram stain showed a Gram-negative bacillus, oxidase + and catalase +, and the biochemical pattern using the API 20 NE strip revealed AX dentrificans. Late posttraumatic meningitis on a possible osteomeningeal breach was diagnosed even though the breach was not confirmed because the patient declined a second brain CT scan. The patient was successfully treated with meropenem.ConclusionsThis report demonstrates the importance of searching for unusual or atypical organisms when the clinician encounters meningitis in a particular context, as well as the importance of adequate follow-up of craniofacial traumas.

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“…Usually, cases of meningitis or ventriculitis caused by A.xylosoxidans were observed to be associated with neurosurgery [8]. However, it is an opportunistic infection and can cause serious problems in humans, especially in immunocompromised patients, such as individuals with HIV/AIDS [11] In the present report, we describe a case of meningitis due to A.xylosoxidans in a neurosurgery patient.…”

Section: Introductionmentioning

confidence: 88%

Postoperative meningitis due to a rare pathogen; Alcaligenes xylosoxidans

et al. 2009

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AbstractAlcaligenes xylosoxidans is non-fermenting gram-negative bacilli found in soil and water. It is an aerobic bacterium in the genus Achromobacter. This bacterium is motile, oxidase positive, and catalase positive, which is isolated uncommonly from clinical specimens. In the present paper, we report a case of meningitis associated with A. xylosoxidans in a 38-year-old male patient post neurosurgery.

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Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

Cited by 11 publications

References 13 publications

Brain Microbial Populations in HIV/AIDS: α-Proteobacteria Predominate Independent of Host Immune Status

Brain Microbial Populations in HIV/AIDS: α-Proteobacteria Predominate Independent of Host Immune Status

A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma

Postoperative meningitis due to a rare pathogen; Alcaligenes xylosoxidans

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