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已发表论文
口腔颌面部间隙感染继发牙髓卟啉单胞菌、解肝素拟杆菌、胸膜炎普雷沃菌及星座链球菌性化脓性脑膜炎一例报告
Authors Yang L , Zeng J, Zhang Y, Li L
Received 2 July 2025
Accepted for publication 27 October 2025
Published 8 November 2025 Volume 2025:18 Pages 5843—5851
DOI https://doi.org/10.2147/IDR.S551081
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Sandip Patil
Linyi Yang,1,* Jingyan Zeng,2,* Yunwei Zhang,1 Linlin Li1
1Department of Neurology, Suining Central Hospital, Suining, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Suining First People’s Hospital, Suining, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Linyi Yang, Department of Neurology, Suining Central Hospital, No. 127 West Desheng Road, Suining, 629000, People’s Republic of China, Tel +86 08252267631, Email yanglinyi1994@163.com
Background: Purulent meningitis caused by polymicrobial oral anaerobes represents a rare but life-threatening clinical challenge, with Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus being pfastidious organisms. Traditional diagnostic methods often fail to identify these fastidious organisms, leading to delayed or inappropriate therapy.
Case Presentation: We report a rare case of purulent meningitis resulting from a polymicrobial infection involving Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus in a 76-year-old male patient who presented with a 40-day history of left facial pain. This case represents the first documented instance of these four oral anaerobes concurrently causing an infection of the central nervous system.
Conclusion: To the best of our knowledge, this case represents the first documented evidence of polymicrobial purulent meningitis caused by oral anaerobes, specifically Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus. Our findings not only provide direct evidence for the oral-central nervous system (CNS) infection pathway but also validate that the valuable approach based on metagenomic next-generation sequencing (mNGS) offers significant clinical insights for diagnostic and therapeutic strategies.
Keywords: purulent meningitis, Porphyromonas endodontalis, Bacteroides heparinolyticus, prevotellapleuritidis, Streptococcus constellatus, oral and maxillofacial space infections, case report
1Department of Neurology, Suining Central Hospital, Suining, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Suining First People’s Hospital, Suining, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Linyi Yang, Department of Neurology, Suining Central Hospital, No. 127 West Desheng Road, Suining, 629000, People’s Republic of China, Tel +86 08252267631, Email yanglinyi1994@163.com
Background: Purulent meningitis caused by polymicrobial oral anaerobes represents a rare but life-threatening clinical challenge, with Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus being pfastidious organisms. Traditional diagnostic methods often fail to identify these fastidious organisms, leading to delayed or inappropriate therapy.
Case Presentation: We report a rare case of purulent meningitis resulting from a polymicrobial infection involving Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus in a 76-year-old male patient who presented with a 40-day history of left facial pain. This case represents the first documented instance of these four oral anaerobes concurrently causing an infection of the central nervous system.
Conclusion: To the best of our knowledge, this case represents the first documented evidence of polymicrobial purulent meningitis caused by oral anaerobes, specifically Porphyromonas endodontalis, Bacteroides heparinolyticus, Prevotella pleuritidis, and Streptococcus constellatus. Our findings not only provide direct evidence for the oral-central nervous system (CNS) infection pathway but also validate that the valuable approach based on metagenomic next-generation sequencing (mNGS) offers significant clinical insights for diagnostic and therapeutic strategies.
Keywords: purulent meningitis, Porphyromonas endodontalis, Bacteroides heparinolyticus, prevotellapleuritidis, Streptococcus constellatus, oral and maxillofacial space infections, case report