Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review

Abstract 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 se...

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Main Authors: Qinghua Li, Xiaotong Fan, Kailiang Wang, Xiaolong Wu, Junjie Li, Yang An, Penghu Wei, Wenli Shi, Yongzhi Shan, Sichang Chen, Guoguang Zhao
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11479-0
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author Qinghua Li
Xiaotong Fan
Kailiang Wang
Xiaolong Wu
Junjie Li
Yang An
Penghu Wei
Wenli Shi
Yongzhi Shan
Sichang Chen
Guoguang Zhao
author_facet Qinghua Li
Xiaotong Fan
Kailiang Wang
Xiaolong Wu
Junjie Li
Yang An
Penghu Wei
Wenli Shi
Yongzhi Shan
Sichang Chen
Guoguang Zhao
author_sort Qinghua Li
collection DOAJ
description Abstract 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.
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spelling doaj-art-c4680b5ac0484d50bd5ee16114feeb352025-08-24T11:10:01ZengBMCBMC Infectious Diseases1471-23342025-08-012511610.1186/s12879-025-11479-0Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature reviewQinghua Li0Xiaotong Fan1Kailiang Wang2Xiaolong Wu3Junjie Li4Yang An5Penghu Wei6Wenli Shi7Yongzhi Shan8Sichang Chen9Guoguang Zhao10Department of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurology, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical UniversityAbstract 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.https://doi.org/10.1186/s12879-025-11479-0Aggregatibacter SegnisSubdural empyemaMetagenomic next-generation sequencingCase report
spellingShingle Qinghua Li
Xiaotong Fan
Kailiang Wang
Xiaolong Wu
Junjie Li
Yang An
Penghu Wei
Wenli Shi
Yongzhi Shan
Sichang Chen
Guoguang Zhao
Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
BMC Infectious Diseases
Aggregatibacter Segnis
Subdural empyema
Metagenomic next-generation sequencing
Case report
title Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
title_full Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
title_fullStr Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
title_full_unstemmed Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
title_short Subdural empyema caused by Aggregatibacter segnis: a rare case report and literature review
title_sort subdural empyema caused by aggregatibacter segnis a rare case report and literature review
topic Aggregatibacter Segnis
Subdural empyema
Metagenomic next-generation sequencing
Case report
url https://doi.org/10.1186/s12879-025-11479-0
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