Lung abscess by Actinomyces odontolyticus and Parvimonas micra co-infection presenting as acute respiratory failure

Abstract

Rationale:Actinomyces odontolyticus and Parvimonas micra are very rare causative organisms of lung abscess and acute respiratory failure.Patient concerns:A 49-year-old male patient visited the emergency room with a complaint of sudden onset of shortness of breath, and he developed acute respiratory failure rapidly.Diagnosis:An abscess in the left lower lung field was diagnosed on the computed tomography scan of chest.Interventions:Immediate treatment with intravenous antibiotics was initiated along with a pigtail catheter insertion for pus drainage.Outcomes:A odontolyticus was cultured on the drained pus and P micra was identified by a blood culture. The patient was successfully weaned from the mechanical ventilator and the lung abscess was completely resolved.Lessons:To the best of our knowledge, this is the first case report of mixed infection with A odontolyticus and P micra, which caused acute respiratory failure in an immune-competent patient. Therefore, physicians should consider the possibility of these organisms as causative pathogens of a fulminant pulmonary infection even in an immune-competent patient.

Clinical characteristics of bloodstream infection by Parvimonas micra: retrospective case series and literature review

“…As the presenting symptoms in these patients were non-specific (e.g., fever, shake, and chills), thorough searches for the primary source of bacteremia may not have been carefully conducted in these 9 cases. In 27 literature cases, P. micra bacteremia were also frequently associated with oropharyngeal infection (7/27, 25.9%) and GIT infection (3/27, 11.1%) [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Other common infectious diseases of P. micra in the literature cases were spondylodiscitis (8/27, 29.6%), intra-abdominal abscess (4/27, 14.8%), IE (3.27, 11.1%), and septic pulmonary emboli (3/27, 11.1%) which is inconsistent with our results.…”

Alteration of the abundance of <em>Parvimonas&nbsp;micra</em> in the gut along the adenoma‑carcinoma sequence

“…micra is a fastidious, anaerobic, gram-positive coccus that is found in healthy human oral and gastrointestinal flora (10). Previous studies have reported that P. micra is involved in lung abscesses, iliopsoas abscesses, gastric carcinogenesis and infections of the periodontal area, soft tissue, bone and joints (11)(12)(13)(14). Currently, based on metagenomic or 16S RNA sequencing analysis, numerous studies have revealed the relationship between P. micra and CRC (15)(16)(17).…”

Prevalence of bacterial pathogens and potential role in COVID-19 severity in patients admitted to intensive care units in Brazil

“…The scenario highlights the high occurrence of potentially virulent pathogens, which can contribute to severity of lung infection in Coronavirus Disease 2019 patients admitted to intensive care units. Moreover, the prevalence of respiratory pathogens observed in COVID-19 patients analyzed can be orchestrated mainly by the complex and distinct immune events in response to lung damage, as well as by the ecological model proposed by Dickson and collaborators (2014, 2015) ( 26, 25 ), which indicate that several lung diseases can alter the growth of local microbiota, leading to an increase in bacterial abundance. A cellular model to explain the bacterial species described in our study correlated to processes that aggravate COVID-19 is presented (Figure 3).…”

“…Furthermore, an association of co-infection by A. odontolyticus and P. micra or Streptococcus spp . to lung abscess and acute respiratory failure was reported ( 26, 27 ). Although respiratory disease caused by these commensals is a rare event, their presence in individuals with compromised immune responses should not be neglected.…”