Cervical spinal epidural abscess and meningitis due to Prevotella oris and Peptostreptococcus micros after retropharyngeal surgery

Excerpt

Sir: We report an unusual case of an epidural spinal abscess caused by Prevotella oris and Peptostreptococcus micros. A 61-year-old male patient with a history of diabetes mellitus was admitted for meningo-encephalitis occurring 1 month after retropharyngeal surgery for a benign tumor. Cerebrospinal fluid (CSF) analyses showed the following: leukocyte count 5,800/mm³ (without altered neutrophil), erythrocyte count less than 1/mm³; protein 1.3 g/l and glucose 3.8 mmol/l. The Gram stain examination was negative. A brain computed tomographic (CT) scan was normal. Empirical antibiotic therapy with ceftriaxone, amoxicillin and cotrimoxazole was started immediately. Two days after his admission, the patient worsened and was referred to the ICU. Clinical examination showed right hemiparesis and bilateral Babinski’s sign. A second CSF analysis showed persistent elevated leukocyte count. Direct examination showed little and pale points into the leukocytes. CSF was inoculated in a blood bottle (Anaerobic Fan medium BacT/Alert, Organon Teknika) and into the usual culture medium. …