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Central nervous system infections due to Stomatococcus mucilaginosus in immunocompromised hosts
M Goldman1, U B Chaudhary, A Greist
1Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, USA.
Abstract:
We present a case of central nervous system (CNS) infection due to Stomatococcus mucilaginosus involving a patient with leukemia and summarize 12 additional published reports of CNS infection due to this organism in immunocompromised hosts. The infection was diagnosed most commonly in the setting of hematologic malignancy accompanied by chemotherapy-induced neutropenia. S. mucilaginosus was recovered from blood prior to discovery of the CNS infection in 62% of cases. Signs or symptoms of CNS infection were observed in all patients. Although a number of patients responded to regimens containing intravenous vancomycin, the addition of intrathecal vancomycin appeared to be of benefit in some cases.
Insights
Central nervous system (CNS) infections caused by Stomatococcus mucilaginosus are rare, particularly in leukemia patients with neutropenia. Intravenous vancomycin, sometimes with intrathecal administration, may treat these serious CNS infections.
Area of Science:
- Infectious Diseases
- Neurology
- Hematology
Background:
- Central nervous system (CNS) infections are serious complications in immunocompromised individuals.
- Stomatococcus mucilaginosus is an opportunistic pathogen rarely implicated in CNS infections.
Observation:
- This report details a case of CNS infection by S. mucilaginosus in a leukemia patient undergoing chemotherapy.
- A review of 12 additional cases highlights CNS infections in immunocompromised hosts, predominantly those with hematologic malignancies and neutropenia.
Findings:
- S. mucilaginosus bacteremia preceded CNS infection diagnosis in 62% of reported cases.
- All patients presented with clinical signs and symptoms indicative of CNS involvement.
- Treatment responses varied, with some patients benefiting from intravenous vancomycin, and others showing improvement with the addition of intrathecal vancomycin.
Implications:
- Early detection and appropriate antimicrobial therapy, potentially including intrathecal vancomycin, are crucial for managing S. mucilaginosus CNS infections in immunocompromised patients.
- This highlights the importance of considering rare pathogens in the differential diagnosis of CNS infections in immunocompromised hosts.
- Further research into optimal treatment strategies for these challenging infections is warranted.