Cerebellar abscess by Gemella morbillorum in a patient with inter-atrial communication

Abstract

-Gemella morbillorum, a commensal of the oropharynx, upper respiratory, urogenital and gastrointestinal tract is rarely associated with infections in humans. However, an increasing number of infectious processes in different locations have been reported. Cerebral abscesses caused by these bacteria are extremely uncommon with only four cases previously described in the literature. We present the case of a cerebellar abscess by Gemella morbillorum in a 50 years-old man with inter-atrial communication dealt by surgical excision and antimicrobial therapy.KEY WORDS: cerebellar abscess, inter-atrial communication, Gemella. Abscesso cerebelar por Gemella morbillorum em paciente com comunicação inter-atrialRESUMO -Gemella morbillorum, uma bactéria comensal da orofaringe, vias aéreas superiores e aparelhos urogenital e gastrointestinal, raramente causa infecções em humanos. No entanto, um crescente número de processos infeciosos em diferentes localizações tem sido referido. Abcessos cerebrais provocados por esta bactéria são extremamente raros, encontrando-se apenas quatro casos previamente descritos na literatura.

Brain abscess caused by gemella morbillorum: a case report and review of literature

“…In contrast, including our case, all but one of the reported cases were immunocompetent (2)(3)(9)(10)(11)14). This underscores the fact that the pathogenic potential of gemella species cannot be underestimated.…”

“…The identification of primary source of infection in reported cases of Gemella morbillorum brain abscess revealed odontogenic infections and dental procedures in the past history of 62.5% of the patients (2,(9)(10)(11)14). Indeed, in our case periodontitis was noted in the past history.…”

“…The majority of the reported cases were cured with this empiric antibiotic combination. However, a few reports document the use of other antibiotic such as vancomycin, clindamycin and a combination of amoxicillin and clavulinc acid, showing the diverse antibiotic sensitivity of gemella (2)(3)(9)(10)(11)14). Although metronidazole susceptibility is a controversial issue in therapy for gemella infections, the broad spectrum antimicrobial activity, good tissue penetrability, moderate adverse effects and low cost justify its use in gemella brain abscess (7).…”

Bactérias isoladas de culicídeos (Diptera: Nematocera) hematófagos em Belém, Pará, Brasil

“…It is a commensal bacterium of the oropharynx, upper respiratory, urogenital and gastrointestinal tracts, although they rarely cause infections in humans. However, a growing number of infections in different locations have 16,25,29 been reported . Brain abscesses caused by this bacterium are extremely rare with only four cases 29 described in scientific literature .…”

Gemella morbillorum Bacteremia after Anti-Tumor Necrosis Factor Alpha as Acne Inversa Therapy

“…It can usually be found as a commensal organism on mucous membranes and is part of the standard oropharyngeal flora. There have been several reports of G. morbillorum as a causative agent in a number of infections, including endocarditis (1,3,11,17,20), septic abscesses (8,10,18), peritonitis (9), and brain abscesses or meningitis (2,12,13,19). Often there is a definite entry point, such as dental defect, oral piercing, or gastrointestinal carcinomas (3,5,6,7,16).…”