Gardnerella vaginalis causing pulmonary infection in a young adult: A novel case

Gardnerella vaginalis is an anaerobic, gram-variable bacterium primarily found in vaginal microflora of women. Previous reports of G. vaginalis cultured in men are few and have primarily been limited to the gastrointestinal and genitourinary tract.^2-4 Few reports of G. vaginalis causing severe infections have been reported in the literature, including septicemia⁷ and two cases of perinephric abscess.^8,9 There has been one previously reported case of G. vaginalis causing pulmonary complications that occurred in a male alcohol abuser. In our case review, we aim to demonstrate an unusual source of a pulmonary infection and highlight the importance of proper microbial isolation to guide treatment. Our patient is a young male who presented following multiple gunshot wounds including one to his head causing an intracranial hemorrhage, hydrocephalus, and a dural sinus thrombosis. His hospital course was complicated by a decline in neurological status treated with a craniotomy and external drain placement and multiple pulmonary infections. During his fever work-ups, he found to have G. vaginalis on mini-bronchoalveolar lavage and was subsequently treated with metronidazole. After treating his G. vaginalis pneumonia and other infectious sources, namely Haemaphilus influenzae and coagulase-negative staphylococcus pneumonias, his fevers and leukocytosis resolved and he was successfully discharged to a rehabilitation facility for neurologic recovery. To our knowledge, this is the second reported case of G. vaginalis isolated from a pulmonary culture and the first in a previously healthy, immunocompetent young male outside of the urinary tract.