PDF(Pubmed)
Abstract：
Helicobacter cinaedi, a gram-negative spiral bacterium, has historically been associated with infections primarily in immunocompromised patients. Recently, however, its potential to cause infections in immunocompetent individuals has been recognized. We report a unique case of a man in his 20 s who reported having sex with men. He presented with symptoms of fever and throat discomfort and was diagnosed with a peritonsillar abscess. While the rapid antigen test for Group A Streptococcus was positive and antibiotics were administered, a puncture fluid from the peritonsillar abscess taken the day after antibiotic treatment revealed the presence of Group C Streptococcus. By the fifth day, the blood culture taken on the first day detected a gram-negative spirochete, which was subsequently identified H. cinaedi. The patient had engaged in oral sex with his male partner, suggesting a potential transmission route. This is significant as H. cinaedi was initially identified from rectal cultures in men who have sex with men (MSM), raising the possibility of pharyngeal transmission through oral sex. In our patient, although H. cinaedi was not isolated from the aspirate of the peritonsillar abscess, its presence in the blood culture and lack of other potential sources of bacteremia make the abscess a likely primary site of infection. This case highlights the importance of considering H. cinaedi as a potential pathogen in immunocompetent patients, particularly in cases of MSM. The potential for H. cinaedi transmission through oral sex and its role in the development of peritonsillar abscesses, a previously unreported association, requires further investigation.
摘要：
幽门螺杆菌,革兰氏阴性螺旋细菌,历史上主要与免疫功能低下患者的感染有关。最近,然而,已经认识到其在有免疫能力的个体中引起感染的潜力。我们报告了一个20多岁的男人报告与男人发生性关系的独特案例。他出现发烧和喉咙不适的症状，并被诊断为扁桃体周围脓肿。虽然A组链球菌的快速抗原检测呈阳性，并给予抗生素，抗生素治疗后第1天,扁桃体周围脓肿穿刺液显示存在C组链球菌.第五天，第一天的血培养检测到革兰氏阴性螺旋体，随后被鉴定为H.cinaedi。病人和他的男性伴侣进行了口交，提示潜在的传播途径。这很重要，因为H.cinaedi最初是从男男性行为者（MSM）的直肠培养物中发现的，通过口交提高咽部传播的可能性。在我们的病人身上，虽然H.cinaedi没有从扁桃体周围脓肿的抽吸中分离出来，它存在于血培养物中，并且缺乏其他潜在的菌血症来源，使得脓肿可能是感染的主要部位。该案例强调了将H.cinaedi视为免疫功能正常患者的潜在病原体的重要性，特别是在MSM的情况下。H.cinaedi通过口交传播的可能性及其在扁桃体周围脓肿发展中的作用，以前未报告的协会，需要进一步调查。
