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Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case

Received: 25 July 2021     Accepted: 9 August 2021     Published: 23 August 2021
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Abstract

Kocuria spp, previously classified as the members of Micrococcacae family, was rarely reported as a human pathogen. Kocuria Kristinae could cause invasive infections of large variety of tissues in patients of any age. We report the first case of meningitis with sixth and third nerve palsies secondary to sphenoid sinusitis caused by Kocuria Kristinae in a previously healthy 13 year-old boy. In effect, his cerebrospinal fluid (CSF) showed a cloudy appearance of the CSF, white blood cells count was 600 cells/µl (polymorphs 90% and 10% lymphocytes), red blood cells count was 200 cells/µl, protein level was elevated at 5.3 g/l and glucose level was low at 0.1 mmol/l. The direct examination showed positive-gram diplococci. The patient was initially treated with intravenous cefotaxim and vancomycin. The CSF culture was positive for gram-positive diplococci, which was identified as Kocuria kristinae. The meningitis was characterized by insidious evolution and persistent very low CSF glucose level. It was difficult to diagnose the sphenoid sinusitis because it is not accessible to direct clinical examination. It was diagnosed after the occurrence of a complication due to its anatomical location and proximity to the intracranial and orbital content. At day 5, the patient had remarkable resolution of symptoms. Complete recovery of cranial nerve palsy was noted at day 8. The aim of this case report is to present the first isolation of Kocuria Kristinae from cerebrospinal fluid sample and describe the clinical presentation and management outcomes.

Published in American Journal of Pediatrics (Volume 7, Issue 3)
DOI 10.11648/j.ajp.20210703.23
Page(s) 159-162
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Kocuria Kristina, Meningitis, Sphenoid Sinusitis, Cranial Nerve Palsies

References
[1] Stackebrandt E, Koch C, Gvozdiak O, Schumann P. Taxonomic dissection of the genus Micrococcus: Kocuria gen. nov., Nesterenkonia gen. nov., Kytococcus gen. nov., Dermacoccus gen. nov., and Micrococcus Cohn 1872 gen. emend. Int J Syst Bacteriol. oct 1995; 45 (4): 682-92.
[2] Dunn R, Bares S, David MZ. Central venous catheter-related bacteremia caused by Kocuria kristinae: case report and review of the literature. Ann Clin Microbiol Antimicrob. 24 août 2011; 10: 31.
[3] Paul M, Gupta R, Khush S, Thakur R. Kocuria rosea: An emerging pathogen in acute bacterial meningitis- Case report.: 4.
[4] Sipahi OR, Mermer S, Aydemir S, Ozgiray E, Cilli F, Oner K. Kocuria rosea meningitis. Surg Infect (Larchmt). oct 2014; 15 (5): 659.
[5] Saitoh A, Beall B, Nizet V. Fulminant bacterial meningitis complicating sphenoid sinusitis. Pediatric Emergency Care. déc 2003; 19 (6): 415-7.
[6] Inc GI, Berger DS. GIDEON Guide to Medically Important Bacteria. GIDEON Informatics Inc; 2020. 2080 p.
[7] Cheung CY, Cheng NHY, Chau KF, Li CS. An Unusual Organism for CAPD-Related Peritonitis: Kocuria kristinae. Perit Dial Int. 1 janv 2011; 31 (1): 107-8.
[8] Chakraborty DB, Banerjee DD. COMBATING KOCURIA: A GAME OF SHADOWS. International Journal of Scientific Research [Internet]. 21 janv 2020 [cité 30 août 2020]; 8 (12). Disponible sur: http://www.worldwidejournals.org/index.php/ijsr/article/view/945.
[9] Brändle G, L’Huillier AG, Wagner N, Gervaix A, Wildhaber BE, Lacroix L. First report of Kocuria marina spontaneous peritonitis in a child. BMC Infect Dis. 30 déc 2014; 14: 719.
[10] Moreira JS, Riccetto AGL, Silva MTN da, Vilela MM dos S, Moreira JS, Riccetto AGL, et al. Endocarditis by Kocuria rosea in an immunocompetent child. Brazilian Journal of Infectious Diseases. févr 2015; 19 (1): 82-4.
[11] Lai CC, Wang JY, Lin SH, Tan CK, Wang CY, Liao CH, et al. Catheter-related bacteraemia and infective endocarditis caused by Kocuria species. Clinical Microbiology and Infection. 1 févr 2011; 17 (2): 190-2.
[12] Tewari R, Dudeja M, Das AK, Nandy S. Kocuria Kristinae in Catheter Associated Urinary Tract Infection: A Case Report. J Clin Diagn Res. août 2013; 7 (8): 1692-3.
[13] Ma ES, Wong CL, Lai KT, Chan EC, Yam W, Chan AC. Kocuria kristinae infection associated with acute cholecystitis. BMC Infectious Diseases. 19 juill 2005; 5 (1): 60.
[14] Basaglia G, Carretto E, Barbarini D, Moras L, Scalone S, Marone P, et al. Catheter-Related Bacteremia Due to Kocuria kristinae in a Patient with Ovarian Cancer. Journal of Clinical Microbiology. 1 janv 2002; 40 (1): 311-3.
[15] Kolikonda MK, Jayakumar P, Sriramula S, Lippmann S. Kocuria kristinae infection during adalimumab treatment. Postgraduate Medicine. 17 févr 2017; 129 (2): 296-8.
[16] Foli M, Rosi N. Synovitis And Periarticular Bursitis Of The Coxofemoral Joint Caused By Kocuria Kristinae: A Case Report. ACTA FACULTATIS MEDICAE NAISSENSIS. 2010; 27 (1): 6.
[17] Bernshteyn M, Kumar PA, Joshi S. Kocuria kristinae pneumonia and bacteremia. Baylor University Medical Center Proceedings. 23 juill 2020; 0 (0): 1-2.
[18] Sivaraman U, Subramanian P, Ramakrishnan K, Seetha KS. Umbilical Sepsis Caused by Multidrug Resistant Strain of Kocuria kristinae in a New Born: A Case Report. J Clin Diagn Res. avr 2016; 10 (4): DD01-2.
[19] Kim KY, Cho JH, Yu CM, Lee KJ, Lee JM, Koh S, et al. A Case of Community-acquired Bacteremic Empyema Caused by Kocuria kristinae. Infect Chemother. juin 2018; 50 (2): 144-8.
[20] Kate A, Joseph J, Bagga B. Kocuria kristinae interface keratitis following deep anterior lamellar keratoplasty. Indian J Ophthalmol. juill 2020; 68 (7): 1463-6.
[21] Del Brutto OH, Caputi R. Isolated abducens palsy due to acute sphenoid sinusitis. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases. 2018; 72: 6-7.
[22] Gupta R, Shukla R, Mishra A, Parihar A. Isolated acute sphenoid sinusitis presenting with hemicranial headache and ipsilateral abducens nerve palsy. BMJ case reports. 8 juin 2015; 2015.
[23] Ada M, Kaytaz A, Tuskan K, Güvenç MG, Selçuk H. Isolated sphenoid sinusitis presenting with unilateral VIth nerve palsy. International Journal of Pediatric Otorhinolaryngology. avr 2004; 68 (4): 507-10.
[24] El Mograbi A, Soudry E. Ocular cranial nerve palsies secondary to sphenoid sinusitis. World Journal of Otorhinolaryngology - Head and Neck Surgery. mars 2017; 3 (1): 49-53.
[25] Zarić RSŽ, Pejčić AV, Janković SM, Kostić MJ, Milosavljević MN, Milosavljević MJ, et al. Antimicrobial treatment of Kocuria kristinae invasive infections: Systematic review. Journal of Chemotherapy. 3 avr 2019; 31 (3): 109-19.
Cite This Article
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    Werdani Amina, Yahyaoui Omar, Jammeli Nesrine, Rassas Ahmed, Boussofara Raoudha, et al. (2021). Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case. American Journal of Pediatrics, 7(3), 159-162. https://doi.org/10.11648/j.ajp.20210703.23

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    ACS Style

    Werdani Amina; Yahyaoui Omar; Jammeli Nesrine; Rassas Ahmed; Boussofara Raoudha, et al. Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case. Am. J. Pediatr. 2021, 7(3), 159-162. doi: 10.11648/j.ajp.20210703.23

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    AMA Style

    Werdani Amina, Yahyaoui Omar, Jammeli Nesrine, Rassas Ahmed, Boussofara Raoudha, et al. Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case. Am J Pediatr. 2021;7(3):159-162. doi: 10.11648/j.ajp.20210703.23

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  • @article{10.11648/j.ajp.20210703.23,
      author = {Werdani Amina and Yahyaoui Omar and Jammeli Nesrine and Rassas Ahmed and Boussofara Raoudha and Khedher Mohamed and Mahjoub Bahri},
      title = {Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case},
      journal = {American Journal of Pediatrics},
      volume = {7},
      number = {3},
      pages = {159-162},
      doi = {10.11648/j.ajp.20210703.23},
      url = {https://doi.org/10.11648/j.ajp.20210703.23},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210703.23},
      abstract = {Kocuria spp, previously classified as the members of Micrococcacae family, was rarely reported as a human pathogen. Kocuria Kristinae could cause invasive infections of large variety of tissues in patients of any age. We report the first case of meningitis with sixth and third nerve palsies secondary to sphenoid sinusitis caused by Kocuria Kristinae in a previously healthy 13 year-old boy. In effect, his cerebrospinal fluid (CSF) showed a cloudy appearance of the CSF, white blood cells count was 600 cells/µl (polymorphs 90% and 10% lymphocytes), red blood cells count was 200 cells/µl, protein level was elevated at 5.3 g/l and glucose level was low at 0.1 mmol/l. The direct examination showed positive-gram diplococci. The patient was initially treated with intravenous cefotaxim and vancomycin. The CSF culture was positive for gram-positive diplococci, which was identified as Kocuria kristinae. The meningitis was characterized by insidious evolution and persistent very low CSF glucose level. It was difficult to diagnose the sphenoid sinusitis because it is not accessible to direct clinical examination. It was diagnosed after the occurrence of a complication due to its anatomical location and proximity to the intracranial and orbital content. At day 5, the patient had remarkable resolution of symptoms. Complete recovery of cranial nerve palsy was noted at day 8. The aim of this case report is to present the first isolation of Kocuria Kristinae from cerebrospinal fluid sample and describe the clinical presentation and management outcomes.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Kocuria Kristinae Meningitis and Cranial Nerve Palsies Secondary to Sphenoid Sinusitis: About a Case
    AU  - Werdani Amina
    AU  - Yahyaoui Omar
    AU  - Jammeli Nesrine
    AU  - Rassas Ahmed
    AU  - Boussofara Raoudha
    AU  - Khedher Mohamed
    AU  - Mahjoub Bahri
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    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    EP  - 162
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20210703.23
    AB  - Kocuria spp, previously classified as the members of Micrococcacae family, was rarely reported as a human pathogen. Kocuria Kristinae could cause invasive infections of large variety of tissues in patients of any age. We report the first case of meningitis with sixth and third nerve palsies secondary to sphenoid sinusitis caused by Kocuria Kristinae in a previously healthy 13 year-old boy. In effect, his cerebrospinal fluid (CSF) showed a cloudy appearance of the CSF, white blood cells count was 600 cells/µl (polymorphs 90% and 10% lymphocytes), red blood cells count was 200 cells/µl, protein level was elevated at 5.3 g/l and glucose level was low at 0.1 mmol/l. The direct examination showed positive-gram diplococci. The patient was initially treated with intravenous cefotaxim and vancomycin. The CSF culture was positive for gram-positive diplococci, which was identified as Kocuria kristinae. The meningitis was characterized by insidious evolution and persistent very low CSF glucose level. It was difficult to diagnose the sphenoid sinusitis because it is not accessible to direct clinical examination. It was diagnosed after the occurrence of a complication due to its anatomical location and proximity to the intracranial and orbital content. At day 5, the patient had remarkable resolution of symptoms. Complete recovery of cranial nerve palsy was noted at day 8. The aim of this case report is to present the first isolation of Kocuria Kristinae from cerebrospinal fluid sample and describe the clinical presentation and management outcomes.
    VL  - 7
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Author Information
  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Microbiology, Taher Sfar University Hospital, Mahdia, Tunisia

  • Department of Pediatrics, Taher Sfar University Hospital, Mahdia, Tunisia

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