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Parvimonas micra orbital cellulitis complicated with cerebral venous thrombosis and mycotic aneurysm

Yeow Hong Sak1, Presaad Pillai2, Ganesan Arthimulam3

  • 1Department of Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia sakyhong@gmail.com.

BMJ Case Reports
|August 8, 2024
PubMed

Insights

Parvimonas micra, a rare oral bacterium, caused severe orbital cellulitis, meningitis, and a carotid artery aneurysm. Successful treatment involved endovascular therapy, antibiotics, and anticoagulation.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • Parvimonas micra is a gram-positive anaerobic coccus found in the human body.
  • While typically commensal, it can cause infections like abscesses and spondylodiscitis.
  • Mycotic aneurysms linked to P. micra are exceptionally rare.

Observation:

  • A patient presented with orbital cellulitis.
  • The infection complicated into meningitis, cerebral venous thrombosis, and an internal carotid artery mycotic aneurysm.
  • P. micra was identified as the causative agent.

Findings:

  • The case details a rare instance of P. micra causing severe, multi-systemic infection.
  • Successful management was achieved through a combination of endovascular therapy and antibiotic treatment.
  • Anticoagulation therapy was administered for six months to manage cerebral venous thrombosis.

Implications:

  • This case highlights the potential for P. micra to cause severe invasive infections beyond its typical sites.
  • It underscores the importance of considering P. micra in the differential diagnosis of complex infections, including mycotic aneurysms.
  • The successful treatment strategy provides a potential therapeutic approach for similar rare presentations.
Keywords:
Infection (neurology)Infectious diseasesInterventional radiology

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