Multiple hepatic and brain abscesses caused by Parvimonas micra: A case report and literature review

Cesta, Novella; Biland, L; Neri, Benedetto; Mossa, Michelangela; Campogiani, Laura; Caldara, F; Zordan, Marta; Petruzziello, C.; Monteleone, Giovanni; Fontana, Carla; Andreoni, Massimo; Sarmati, Loredana

doi:10.1016/j.anaerobe.2021.102366

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…In terms of prognosis, 72 patients (87.80%) exhibited a gradual recovery from the infection, while 10 patients (12.20%) succumbed to multiorgan failure (14,36,(39)(40)(41)(42)(43)(44), the majority of whom presented severe comorbid underlying conditions such as cardiovascular diseases, neoplasms, and immune-related diseases. This underscores the imperative need for heightened vigilance regarding P. micra infection, particularly in individuals predisposed to compromised oral hygiene, diabetes mellitus, malignancy, and cardiovascular and cerebrovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

Hemoptysis caused by Parvimonas micra: case report and literature review

Shao,

He,

Jiao

et al. 2024

Front. Public Health

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BackgroundParvimonas micra (P. micra), a Gram-positive anaerobic bacterium, exhibits colonization tendencies on oral mucosal and skin surfaces, potentially evolving into a pathogenic entity associated with diverse diseases. The diagnostic trajectory for P. micra-related diseases encounters delays, often with severe consequences, including fatality, attributed to the absence of symptom specificity and challenges in culture. The absence of a consensus on the diagnostic and therapeutic approaches to P. micra exacerbates the complexity of addressing associated conditions. This study aims to elucidate and scrutinize the clinical manifestations linked to P. micra, drawing insights from an extensive literature review of pertinent case reports.Case presentationA 53-year-old male sought medical attention at our institution presenting with recurrent hemoptysis. Empirical treatment was initiated while awaiting pathogen culture results; however, the patient’s symptoms persisted. Subsequent metagenomic next-generation sequencing (mNGS) analysis revealed a pulmonary infection attributable to P. micra. Resolution of symptoms occurred following treatment with piperacillin sulbactam sodium and moxifloxacin hydrochloride. A comprehensive literature review, utilizing the PubMed database, was conducted to assess case reports over the last decade where P. micra was identified as the causative agent.ConclusionThe literature analysis underscores the predilection of P. micra for immunocompromised populations afflicted by cardiovascular diseases, diabetes, orthopedic conditions, and tumors. Risk factors, including oral and periodontal hygiene, smoking, and alcohol consumption, were found to be associated with P. micra infections. Clinical manifestations encompassed fever, cough, sputum production, and back pain, potentially leading to severe outcomes such as Spondylodiscitis, septic arthritis, lung abscess, bacteremia, sepsis, and mortality. While conventional bacterial culture remains the primary diagnostic tool, emerging technologies like mNGS offer alternative considerations. In terms of treatment modalities, β-lactam antibiotics and nitroimidazoles predominated, exhibiting recovery rates of 56.10% (46/82) and 23.17% (19/82), respectively. This case report and literature review collectively aim to enhance awareness among clinicians and laboratory medicine professionals regarding the intricacies of P. micra-associated infections.

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Section: Discussionmentioning

confidence: 99%

Hemoptysis caused by Parvimonas micra: case report and literature review

Shao,

He,

Jiao

et al. 2024

Front. Public Health

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“…However, it can be a pathogen in patients with impaired immune function or with underlying disease. Cases of P. micra infection of the hip joint, pericardium, cervix, liver, and brain have been reported (4,(16)(17)(18). However, because of the aerobic environment of the lung, this pathogen is not common in the lung and it rarely causes pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…This opportunistic pathogen is frequently isolated from infected root canals of teeth with chronic apical periodontitis, whereas remote infections are rare (2). A few sporadic cases of remote infection in patients with underlying diseases or a recent oral operation have been reported (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia

Feng

Wu²,

Huang³

et al. 2022

Front. Med.

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Parvimonas micra is an anaerobic Gram-positive coccus frequently found in the oral cavity and gastrointestinal tract, but rarely in the lung. Therefore, pneumonia caused by P. micra is also rare. Although there are some reports of P. micra related pneumonia due to aspiration or blood-borne infection with definite remote infection source, there are no reported cases of hematogenous P. micra pneumonia in healthy adults lacking a remote source of infection. Herein, we described the intact disease of P. micra-related pneumonia mimicking hematogenous Staphylococcus aureus pneumonia in terms of chest imagery and diagnosed via metagenomic next-generation sequencing (mNGS). Interestingly, there was no clear remote pathogenic source identified in the patient. Microbiome analysis revealed dysbiosis of the oral flora possibly related to poor oral hygiene and a long history of smoking. The patient was treated with moxifloxacin for 3 months. Ultimately, computed tomography (CT) of the chest showed total resolution of the lung lesion. Clinicians need to update the etiology of community-acquired pneumonia. When antibiotic therapy is not effective, pathogen examination becomes very important. New methods of pathogen detection such as mNGS should be employed to this end. For the treatment of P. micra pneumonia, no standardized course of treatment was reported. Imaging absorption of lung infections may provide a more objective guidance for the duration of antibiotics in P. micra pneumonia.

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“…This subacute and chronic course can be caused by anaerobic microorganisms, such as Parvimonas micra, a Gram-positive anaerobic coccus found mainly in the oral cavity, respiratory system, and gastrointestinal and female genitourinary tracts. It is rare to find this microorganism outside these locations; however, cases of bacteriemia, endocarditis, septic arthritis, osteomyelitis, and abscesses have been reported [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Case Report and Literature Review of Parvimonas micra: Difficult-to-Treat Arthritis in Hiding

Cenicacelaya Olabarrieta,

Cabello Vallejo,

Morell-Hita

et al. 2023

Healthcare

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Septic arthritis is a life-threatening rheumatological syndrome that is highly related to a patient’s immune status and comorbidities, and although the most common clinical presentation is rapid-onset monoarthritis, it can also appear as subacute or chronic joint swelling. In these cases, differential diagnosis is more challenging, but early diagnosis and treatment is no less urgent to ensure a good global prognosis and the best outcome of the affected joint. Anaerobic microorganisms, such as Parvimonas micra, are an uncommon cause of septic arthritis (less than 5% of cases) but may be the cause of subacute arthritis. Knowledge about Parvimonas micra is important, as it is difficult to culture in the laboratory and generates a synovial fluid with atypical characteristics for septic arthritis so that, if not suspected, its diagnosis can be easily overlooked and underdiagnosed. We present the case of a 76-year-old woman with subacute arthritis of the left knee, describe the difficult diagnosis and treatment of its unexpected cause (Parvimonas micra), and review previously described cases, identifying the possible common comorbidities that may help clinicians easily find and treat this cause of subacute septic arthritis.

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Multiple hepatic and brain abscesses caused by Parvimonas micra: A case report and literature review

Cited by 11 publications

References 19 publications

Hemoptysis caused by Parvimonas micra: case report and literature review

Hemoptysis caused by Parvimonas micra: case report and literature review

Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia

Case Report and Literature Review of Parvimonas micra: Difficult-to-Treat Arthritis in Hiding

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