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Identification of Rare Bacterial Pathogens by 16S rRNA Gene Sequencing and MALDI-TOF MS
06:34

Identification of Rare Bacterial Pathogens by 16S rRNA Gene Sequencing and MALDI-TOF MS

Published on: July 11, 2016

[Case of subdural empyema caused by Porphyromonas and Fusobacterium identified by 16S ribosomal RNA gene sequence

Saiko Aiba1, Yuka Watanabe, Masaaki Odaka

  • 1Department of Neurology, Dokkyo Medical University.

Rinsho Shinkeigaku = Clinical Neurology
|June 12, 2010
PubMed

Insights

A rare case of subdural empyema caused by Porphyromonas and Fusobacterium sinusitis is presented. Molecular typing identified bacteria when cultures failed, guiding treatment for this serious brain infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Subdural empyema is a rare but serious complication of sinusitis.
  • Odontogenic infections can lead to sinusitis and subsequent intracranial spread.
  • Porphyromonas and Fusobacterium are anaerobic bacteria often implicated in head and neck infections.

Observation:

  • A young woman presented with symptoms of meningitis and subdural empyema secondary to sinusitis.
  • Initial diagnostic cultures from CSF and biopsy were negative.
  • Brain MRI revealed leptomeningeal enhancement and edema consistent with infection.

Findings:

  • Molecular typing (16S rRNA sequencing) identified Porphyromonas and Fusobacterium in the absence of positive cultures.
  • Initial broad-spectrum antibiotics (meropenem, vancomycin) led to neurological deterioration.
  • Subsequent targeted therapy with cephalosporin and metronidazole resulted in clinical improvement.

Implications:

  • Clinicians should consider Porphyromonas and Fusobacterium as potential pathogens in subdural empyema secondary to sinusitis.
  • 16S rRNA gene sequencing is a valuable tool for diagnosing infections when conventional cultures are negative.
  • Early and accurate diagnosis and targeted antimicrobial therapy are crucial for favorable outcomes in brain infections.

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