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BMJ Case Reports 2013; doi:10.1136/bcr-2012-007252
  • CASE REPORT

Immunocompetent young man with cerebral abscess and cortical venous infarction mimicking cerebritis caused by Gemella morbillorum

  1. Claudius Bartels1
  1. 1Department of Neurology, University Medical Center Magdeburg A.ö.R, Magdeburg, Germany
  2. 2Department of Neuroradiology, University of Magdeburg, Magdeburg, Germany
  3. 3Department of Microbiology, University of Magdeburg, Magdeburg, Germany
  1. Correspondence to Annette Milnik, annette.milnik{at}unibas.ch

Summary

Gemella morbillorum is an anaerobic gram-positive diplococcus and in most cases a harmless commensal, which occasionally causes infections in the central nervous system. We report on an immunocompetent young man with focal neurological symptoms and cephalgia caused by a cerebral abscess. Although successful treatment was done with neurosurgical intervention and antibiotic therapy, he suffered from a venous infarction 5 weeks after first diagnosis, which mimicked cerebritis as an early stage of relapsing abscess. Imaging and investigation of cerebrospinal fluid was necessary for sufficient differential diagnosis and antibiotic therapy could be stopped after altogether 8 weeks of treatment. In summary, G morbillorum causes not only biphasic infections, but also can be accompanied by infarction in the central nervous system despite sufficient antibiotic therapy.

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