Meningitis and Septicemia Due to Neisseria cinerea

Kirchgesner, Véronique; Plésiat, Patrick; Dupont, Marie Jeanne; Estavoyer, J.M.; Guibourdenche, M.; Riou, J.Y.; Michel-Briand, Y

doi:10.1093/clinids/21.5.1351

Cited by 15 publications

(11 citation statements)

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“…This microbe is known as a non-pathogenic strain that does not usually cause disease [1][2][3][4]. Some cases caused by N. cinerea have been reported however, including ophthalmia neonatorum [2], nosocomial pneumonia [3], bacterial peritonitis [5], proctitis [6], tricuspid valve endocarditis [7], meningitis [8,10], acute septic arthritis and skin abscess [9].…”

Section: Discussionmentioning

confidence: 99%

“…N. cinerea rarely causes infective diseases. Nevertheless, a variety of diseases caused by N. cinerea have been reported as follows; ophthalmia neonatorum [2], nosocomial pneumonia [3], recurrent bacterial peritonitis in peritoneal dialysis patient [5], proctitis [6], endocarditis [7], meningitis and septicemia [8]. However, in Korea, cases of acute septic arthritis and skin abscess [9], and meningitis [10] caused by N. cinerea were reported.…”

Section: Introductionmentioning

confidence: 99%

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Infective Endocarditis Caused byNeisseria cinereain a 7-Year-Old Girl Who Had Undergone Surgical Pulmonary Valve Replacement

Kim

Jang

et al. 2017

Ewha Med J

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Infective Endocarditis Caused byNeisseria cinereain a 7-Year-Old Girl Who Had Undergone Surgical Pulmonary Valve Replacement

Kim

Jang

et al. 2017

Ewha Med J

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“…Despite DGI being a rare complication, its incidence is currently increasing relative to the steady increase in the incidence of gonorrhea worldwide [45]. N. cinerea Blood Septicemia [127,128] Brain Meningitis [128] Genitourinary tract Genital infections [129] Urinary infection [130] Peritoneum Peritonitis [131] Eye Conjunctivitis/ophthalmia neonatorum [132,133] N. dumasiana Sputum (Insufficient clinical data) [134] N. elongata Heart Endocarditis [135,136] Blood Septicemia [137] Bone Osteomyelitis [138] N. flava Heart Rheumatic heart disease/ventricular septaldefect/endocarditis [139] Endocarditis [140] Blood Sepsis/conjunctival petechia [139] N. flavescens Heart Endocarditis [141,142] Brain Meningitis [143,144] Blood Septicemia [145,146] Lung Pneumonia/empyema [147] Genitourinary tract Genital infections [148] N. lactamica Brain Meningitis [149,150] Blood Septicemia [145,151] Pharynx Pharyngitis [152] Lung Cavitary lesion [153] Pneumonia [154] Genitourinary tract Genital infections [129,155,156] N. mucosa Heart Endocarditis [157][158][159] Brain Meningitis [160,161] Blood Septicemia…”

Section: Disseminated Gonococcal Infections (Dgis)mentioning

confidence: 99%

“…other than N. meningitidis and N. gonorrhoeae identified as causing meningitis include N. flavescens [143,144], N. lactamica [149,150], N. mucosa [160,161], N. sicca [177,178], and N. subflava [185][186][187]. Moreover, several non-gonococcal, non-meningococcal Neisseria species have been isolated from blood cultures, many of which have been associated with infections including endocarditis (see above, Section 4.1), septicemia and meningitis [124,127,128,137,139,145,146,151,162,169,186,190] ( Table 1).…”

Section: Meningitis and Septicemiamentioning

confidence: 99%

Atypical, Yet Not Infrequent, Infections with Neisseria Species

Humbert

Christodoulides

2019

Pathogens

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Neisseria species are extremely well-adapted to their mammalian hosts and they display unique phenotypes that account for their ability to thrive within niche-specific conditions. The closely related species N. gonorrhoeae and N. meningitidis are the only two species of the genus recognized as strict human pathogens, causing the sexually transmitted disease gonorrhea and meningitis and sepsis, respectively. Gonococci colonize the mucosal epithelium of the male urethra and female endo/ectocervix, whereas meningococci colonize the mucosal epithelium of the human nasopharynx. The pathophysiological host responses to gonococcal and meningococcal infection are distinct. However, medical evidence dating back to the early 1900s demonstrates that these two species can cross-colonize anatomical niches, with patients often presenting with clinically-indistinguishable infections. The remaining Neisseria species are not commonly associated with disease and are considered as commensals within the normal microbiota of the human and animal nasopharynx. Nonetheless, clinical case reports suggest that they can behave as opportunistic pathogens. In this review, we describe the diversity of the genus Neisseria in the clinical context and raise the attention of microbiologists and clinicians for more cautious approaches in the diagnosis and treatment of the many pathologies these species may cause.

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“…It is a commensal of the human oropharynx and sometimes the urogenital tract with low pathogenic potential, although invasive infections are rarely reported. One case of posttraumatic meningitis and bacteremia (12), four episodes of bacteremia, two of these in immunocompromised patients and resulting in death (13)(14)(15), one case of endocarditis in an intravenous drug user (16), three episodes of continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis in two different patients (17,18), two cases of pulmonary infections in immunosuppressed patients (19,20), one case of proctitis (initially misidentified as N. gonorrhoeae) in a child (21), and several cases of purulent conjunctivitis in neonates (22) have been described so far.…”

Section: Case Reportmentioning

confidence: 99%

Meningitis and Bacteremia Due to Neisseria cinerea following a Percutaneous Rhizotomy of the Trigeminal Ganglion

et al. 2016

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e Neisseria cinerea is a human commensal. The first known case of meningitis and bacteremia due to Neisseria cinerea following percutaneous glycerol instillation of the trigeminal ganglion is reported. Conventional phenotypic methods and complete 16S RNA gene sequencing accurately identified the pathogen. Difficulties in differentiation from pathogenic neisseriae are discussed. CASE REPORTA 58-year-old male patient presented the day after a percutaneous glycerol rhizotomy of the trigeminal ganglion with fever (38.2°C), clinical signs of meningitis without new focal neurologic deficits, and a normal neurocognitive status.His personal history was remarkable for severe trigeminal neuralgia refractory to medical treatment and for diagnosis of primary progressive multiple sclerosis for 13 years without immunosuppressive treatment.His white blood cell count (18.9 G/liter; 90% neutrophils, no left shift) and his C-reactive protein level (189 mg/dl) were elevated. Two sets of blood cultures and a lumbar puncture were immediately performed, and empirical antibiotic treatment with intravenous (i.v.) ceftriaxone administered in two doses at 2 g per dose (2x2g) was started. The cerebrospinal fluid (CSF) sample showed 4,125 nuclear cells/l, with 89% polymorphonuclear neutrophils. Protein and glucose (GLU) levels were abnormal, with 1.32 g (normal, 0.15 to 0.45) of protein/liter and 0.29 mmol (normal, 2.2 to 3.9) of glucose/liter in the CSF. Gram staining of the CSF revealed Gram-labile cocci.A computed tomography (CT) scan showed a small amount of intracerebral air near the trigeminal ganglion, confirming accidental involvement of intracerebral structures during rhizotomy (Fig. 1A). Flucloxacillin (6x2g) was added to the regimen. Droplet isolation precautions were not considered necessary because the clinical picture was suggestive for iatrogenic complication and not for meningococcal meningitis (1, 2).The following day, Neisseria species, susceptible to penicillin, ampicillin, ceftriaxone, and ciprofloxacin, grew in one of two sets of blood cultures and the CSF cultures (Table 1). Flucloxacillin treatment was stopped, and ceftriaxone treatment was continued for 7 days in total, according to the recommended treatment duration for meningitis due to N. meningitidis (3). The patient recovered rapidly. After 1 week, he was asymptomatic, with normal blood values.The CSF isolate was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis (MALDI BioTyper; Bruker Daltonik, Bremen, Germany) as Neisseria meningitidis, with a score of 1.82 (sufficient only for genus assignment). Neisseria cinerea was the third species proposed by MALDI-TOF MS, with a minimal difference in the score (1.81). The colony morphology turned out to show no pigmentation. API NH V3.0 (bioMérieux Suisse SA, Geneva, Switzerland) testing was performed, with a positive reaction only for ProA, consistent with N. cinerea, and negative test results for glucose (GLU), maltose (MAL), and ␥-glutamyl aminopeptidas...

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Meningitis and Septicemia Due to Neisseria cinerea

Cited by 15 publications

References 0 publications

Infective Endocarditis Caused byNeisseria cinereain a 7-Year-Old Girl Who Had Undergone Surgical Pulmonary Valve Replacement

Infective Endocarditis Caused byNeisseria cinereain a 7-Year-Old Girl Who Had Undergone Surgical Pulmonary Valve Replacement

Atypical, Yet Not Infrequent, Infections with Neisseria Species

Meningitis and Bacteremia Due to Neisseria cinerea following a Percutaneous Rhizotomy of the Trigeminal Ganglion

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