Document Detail


Identification of Streptococcus intermedius central nervous system infection by use of PCR and electrospray ionization mass spectrometry.
MedLine Citation:
PMID:  23035188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe the utility of PCR and electrospray ionization with mass spectrometry (PCR/ESI-MS) of culture-negative cerebrospinal fluid (CSF) in order to identify Gram-positive cocci noted on a Gram stain of CSF from a previously healthy 26-year-old man with community-acquired pneumonia (CAP) and multiple brain abscesses. CSF samples were obtained 2 weeks apart, first by lumbar puncture and 2 weeks later from an external ventricular drain that was inserted into the right ventricle. Both CSF cultures were negative. A Gram stain of bronchoalveolar lavage (BAL) fluid was notable for many Gram-positive cocci (GPC), but cultures of BAL fluid and subcarinal lymph node biopsy tissue were negative. PCR/ESI-MS detected Streptococcus intermedius, a common cause of brain abscesses, in both CSF samples as well as in the fixed tissue from the biopsy. This unique case confirms S. intermedius pulmonary infection as the source of metastatic CNS infection and reveals the potential of PCR/ESI-MS to detect a streptococcal pathogen not captured by conventional cultures.
Authors:
Nisha S Bhatia; John J Farrell; Rangarajan Sampath; Raymond Ranken; Megan A Rounds; David J Ecker; Robert A Bonomo
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-10-03
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  50     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-19     Completed Date:  2013-04-17     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4160-2     Citation Subset:  IM    
Affiliation:
Illinois Neurological Institute, Peoria, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bacteriological Techniques / methods
Brain Abscess / complications,  microbiology
Central Nervous System Infections / microbiology*
Cerebrospinal Fluid / microbiology
Humans
Male
Pneumonia, Bacterial / complications,  microbiology
Polymerase Chain Reaction / methods*
Spectrometry, Mass, Electrospray Ionization / methods*
Streptococcal Infections / diagnosis*,  microbiology
Streptococcus intermedius / chemistry,  genetics,  isolation & purification*
Grant Support
ID/Acronym/Agency:
R01 AI063517/AI/NIAID NIH HHS
Comments/Corrections

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