Who is the culprit of persistent unimproved central nervous system infection? Brain abscess caused by Mycoplasma hominis:case report and review of literatures

Abstract Background Mycoplasma hominis is slow growing organism lacking a cell wall,thus they have no positive results of Gram staining.Their bacterial colonies are small,thus they are easy to miss out on culture medium.So Mycoplasma hominis infection is difficult to identify.When the central nervous system infection caused by Mycoplasma hominis occurs,because it is difficult to identify and is resistant to empirical anti-infective drugs,treatments may be failed.Mycoplasma hominis has a tendency of purulent aggregation,so the central nervous system infection is easy to develop to brain abscess,which cause fatal complications. Case Presentation: The article describes a 69-year-old male who suffered from central nervous infection after head trauma,but the cerebrospinal fluid Gram staining and culture continued to be negative,the empirical anti-infection program did not achieve effects,the patient continued to have fever,and then developed with brain abscess.The patient was given brain abscess debridement,and the debridement secreta was sent to mNGS(Metallic next generation sequencing) examination.The pathogenic bacterium definitely confirmed Mycoplasma hominis.The anti-infection program was adjusted,and finally he recovered.mNGS can detect all microbial genome in the sample,allowing clinicians detect pathogens through a single test making accurately diagnose and selecting the correct anti-infection program.Mycoplasma hominis was sensitive to chloramphenicol,tetracycline,and fluoroquinolones,so these drugs were used for its infection.We explore the characteristics of central nervous infection which caused by mycoplasma hominis and review of the literatures. Conclusions Clinicians should pay attention to the early identification and mNGS examination of central nervous system infection caused by Mycoplasma hominis,and selecting the correct anti-infection program and treatments early to save lives.