Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing
BackgroundExtraoral infection by Porphyromonas gingivalis (P. gingivalis) is extremely rare and challenging to diagnose because the fastidious pathogen is difficult to culture by traditional methods. We report the first case of a patient with multiple abscesses in muscles and the brain with dura emp...
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| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1089863/full |
| _version_ | 1797942939279687680 |
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| author | Yichen Zhang Youfeng Zhu Huijuan Wan |
| author_facet | Yichen Zhang Youfeng Zhu Huijuan Wan |
| author_sort | Yichen Zhang |
| collection | DOAJ |
| description | BackgroundExtraoral infection by Porphyromonas gingivalis (P. gingivalis) is extremely rare and challenging to diagnose because the fastidious pathogen is difficult to culture by traditional methods. We report the first case of a patient with multiple abscesses in muscles and the brain with dura empyema due to P. gingivalis, which was diagnosed by metagenomic next-generation sequencing (mNGS).Case presentationA 65-year-old male patient was admitted to our hospital for multiple lumps in his body. Brain magnetic resonance imaging (MRI) and lower-limb computed tomography (CT) revealed multiple abscesses in the brain and muscles. A diagnosis of P. gingivalis infection was made based on mNGS tests of blood, cerebrospinal fluid (CSF), and pus samples, as the traditional bacterial culture of these samples showed negative results. Target antibiotic therapy with meropenem and metronidazole was administered, and CT-guided percutaneous catheter drainage of abscesses in both thighs was performed. The size of muscle abscesses reduced significantly and neurological function improved. The patient was followed up for 4 months. No abscesses re-appeared, and the remaining abscesses in his backside and both legs were completely absorbed. He can speak fluently and walk around freely without any neurological deficits.ConclusionMetagenomic next-generation sequencing is helpful for early diagnosis and subsequent treatment of P. gingivalis-associated multiple abscesses. |
| first_indexed | 2024-04-10T20:16:27Z |
| format | Article |
| id | doaj.art-4052d6e6fc434388af96c38b2c4f4ee2 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T20:16:27Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-4052d6e6fc434388af96c38b2c4f4ee22023-01-26T04:48:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-01-01910.3389/fmed.2022.10898631089863Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencingYichen Zhang0Youfeng Zhu1Huijuan Wan2Department of Intensive Care Unit, Guangzhou Red Cross Hospital, Guangzhou, ChinaDepartment of Intensive Care Unit, Guangzhou Red Cross Hospital, Guangzhou, ChinaDepartment of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBackgroundExtraoral infection by Porphyromonas gingivalis (P. gingivalis) is extremely rare and challenging to diagnose because the fastidious pathogen is difficult to culture by traditional methods. We report the first case of a patient with multiple abscesses in muscles and the brain with dura empyema due to P. gingivalis, which was diagnosed by metagenomic next-generation sequencing (mNGS).Case presentationA 65-year-old male patient was admitted to our hospital for multiple lumps in his body. Brain magnetic resonance imaging (MRI) and lower-limb computed tomography (CT) revealed multiple abscesses in the brain and muscles. A diagnosis of P. gingivalis infection was made based on mNGS tests of blood, cerebrospinal fluid (CSF), and pus samples, as the traditional bacterial culture of these samples showed negative results. Target antibiotic therapy with meropenem and metronidazole was administered, and CT-guided percutaneous catheter drainage of abscesses in both thighs was performed. The size of muscle abscesses reduced significantly and neurological function improved. The patient was followed up for 4 months. No abscesses re-appeared, and the remaining abscesses in his backside and both legs were completely absorbed. He can speak fluently and walk around freely without any neurological deficits.ConclusionMetagenomic next-generation sequencing is helpful for early diagnosis and subsequent treatment of P. gingivalis-associated multiple abscesses.https://www.frontiersin.org/articles/10.3389/fmed.2022.1089863/fullPorphyromonas gingivalisnext generation sequencing (NGS)multiple abscessesmetronidazolepercutaneous catheter drainage |
| spellingShingle | Yichen Zhang Youfeng Zhu Huijuan Wan Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing Frontiers in Medicine Porphyromonas gingivalis next generation sequencing (NGS) multiple abscesses metronidazole percutaneous catheter drainage |
| title | Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing |
| title_full | Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing |
| title_fullStr | Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing |
| title_full_unstemmed | Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing |
| title_short | Case report:Multiple abscesses caused by Porphyromonas gingivalis diagnosed by metagenomic next-generation sequencing |
| title_sort | case report multiple abscesses caused by porphyromonas gingivalis diagnosed by metagenomic next generation sequencing |
| topic | Porphyromonas gingivalis next generation sequencing (NGS) multiple abscesses metronidazole percutaneous catheter drainage |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1089863/full |
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