涉及Solobacterium moorei和Slackia exigua的多微生物厌氧性脑膜炎伴脑室炎：一例病例报告

文献信息

中文摘要

厌氧菌是细菌性脑膜炎不常见的病因。我们报告一例罕见的由Slackia exigua和Solobacterium moorei（两者均为口腔厌氧菌）引起的多微生物厌氧性脑膜炎伴脑室炎。一名41岁女性表现为头痛、呕吐和意识障碍。脑脊液分析符合细菌性脑膜炎，培养出S. exigua和S. moorei，经基质辅助激光解吸电离飞行时间质谱鉴定，并通过16S rRNA基因测序确认S. exigua。血培养显示多微生物菌血症，包括S. exigua、Streptococcus anginosus和Desulfovibrio falkowii。D. falkowii的鉴定通过16S rRNA基因测序进行，并由全基因组测序证实。未经治疗的龋齿、牙周炎和鼻窦炎被认为是可能的入侵门户。患者对持续使用氨苄西林/舒巴坦和甲硝唑的抗菌治疗反应良好。本病例突出了罕见口腔厌氧菌在中枢神经系统感染中的临床相关性。它强调了厌氧性脑膜炎的多微生物性质，并说明了结合传统培养、基质辅助激光解吸电离飞行时间质谱和分子方法鉴定不常见病原体的潜在价值。

英文摘要

Anaerobic bacteria are uncommon causes of bacterial meningitis. We report a rare case of polymicrobial anaerobic meningitis with ventriculitis involving Slackia exigua and Solobacterium moorei, both oral anaerobes. A 41-year-old woman presented with headache, vomiting, and impaired consciousness. Cerebrospinal fluid analysis was consistent with bacterial meningitis, and cultures yielded S. exigua and S. moorei, identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry, with S. exigua confirmed by 16S rRNA gene sequencing. Blood cultures showed polymicrobial bacteremia, including S. exigua, Streptococcus anginosus, and Desulfovibrio falkowii. The identification of D. falkowii was performed using 16S rRNA gene sequencing and corroborated by whole-genome sequencing. Untreated dental caries, periodontitis, and sinusitis were considered potential portals of entry. The patient responded favorably to continued antimicrobial therapy with ampicillin/sulbactam and metronidazole. This case highlights the clinical relevance of rare oral anaerobes in central nervous system infections. It underscores the polymicrobial nature of anaerobic meningitis and illustrates the potential value of combining conventional culture, matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and molecular methods in identifying uncommon pathogens.