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Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
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Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
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Journal Article
Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
2025
Overview
Background
Aggregatibacter
species are Gram-negative bacteria typically recognized as oral saprophytes in humans, with invasive infections uncommon in immunocompetent individuals. To the best our knowledge, this is the first reported case of subdural empyema attributed to
Aggregatibacter segnis
(
A. segnis
).
Case presentation
A 50-year-old female was transferred to our hospital from a local facility due to headache, fever, and left-sided limb numbness. Initially suspected of subdural hematoma and viral encephalitis, she did not respond well to prior treatment. Cerebral computed tomography and magnetic resonance imaging revealed a subdural lesion in the frontal-temporal region and sinusitis. Virus-related tests, smear, and culture of cerebrospinal fluid (CSF) were negative. Craniotomy was performed to evacuate the subdual empyema, and
A. segnis
was detected in the culture of pus. The discrepancy between metagenomic next-generation sequencing (mNGS) and culture highlights diagnostic challenges in this pretreated patient. Antibiotic treatment was guided by culture results and mNGS. Clinical symptoms resolved gradually following surgery and administration of antibiotics.
Conclusions
This rare case suggested that
A. segnis
should be considered in the diagnosis of subdural empyema. Multimodal diagnostics, prompt neurosurgical management, and individualized antimicrobial stewardship are crucial in managing rare central nervous system infections.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Anti-Bacterial Agents - therapeutic use
/ Bacteria
/ Blood
/ Brain
/ Complications and side effects
/ Empyema
/ Empyema, Subdural - diagnosis
/ Empyema, Subdural - diagnostic imaging
/ Empyema, Subdural - drug therapy
/ Empyema, Subdural - microbiology
/ Epidural
/ Female
/ Females
/ Fever
/ Headache
/ Hematoma
/ Humans
/ Medicine
/ Meninges
/ Metagenomic next-generation sequencing
/ Nausea
/ Pain
/ Pasteurellaceae - isolation & purification
/ Pasteurellaceae Infections - diagnosis
/ Pasteurellaceae Infections - drug therapy
/ Pasteurellaceae Infections - microbiology
/ Sinuses
/ Surgery
/ Vomiting
