Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 1131-1139
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.1131
Mycoplasma hominis meningitis after operative neurosurgery: A case report and review of literature
Nian-Long Yang, Xiao Cai, Qing Que, Hua Zhao, Kai-Long Zhang, Sheng Lv
Nian-Long Yang, Qing Que, Hua Zhao, Kai-Long Zhang, Sheng Lv, Department of Critical Care Medicine, Central Hospital of Panzhihua, Panzhihua 617000, Sichuan Province, China
Xiao Cai, School of Health and Wellness, Panzhihua University, Panzhihua 617000, Sichuan Province, China
Author contributions: Cai X and Yang NL conceived the central idea, analyzed clinical data and wrote the initial draft; all authors participated in the clinical diagnosis and revised the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xiao Cai, RN, Assistant Lecturer, Nurse, School of Health and wellness, Panzhihua University, No. 10 Jichang Road, East District, Panzhihua 617000, Sichuan Province, China.
Received: July 25, 2021
Peer-review started: July 25, 2021
First decision: October 22, 2021
Revised: November 4, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: January 21, 2022

Mycoplasma hominis (M. hominis), which causes central nervous system infections in adults, is very rare. It is also relatively difficult to culture mycoplasma and culturing requires special media, resulting in a high rate of clinical underdiagnosis. Therefore, clinicians often treat patients based on their own experience before obtaining pathogenic results and may ignore infections with atypical pathogens, thus delaying the diagnosis and treatment of patients and increasing the length of hospital stay and costs.


A 44-year-old man presented to the hospital complaining of recurrent dizziness for 1 year, which had worsened in the last week. After admission, brain magnetic resonance imaging (MRI) revealed a 7.0 cm × 6.0 cm × 6.1 cm lesion at the skull base, which was irregular in shape and had a midline shift to the left. Based on imaging findings, meningioma was our primary consideration. After lesion resection, the patient had persistent fever and a diagnosis of suppurative meningitis based on cerebrospinal fluid (CSF) examination. The patient was treated with the highest level of antibiotics (meropenem and linezolid), but the response was ineffective. Finally, M. hominis was detected by next-generation metagenomic sequencing (mNGS) in the CSF. Therefore, we changed the antibiotics to moxifloxacin 0.4 g daily combined with doxycycline 0.1 g twice a day for 2 wk, and the patient had a normal temperature the next day.


Mycoplasma meningitis after neurosurgery is rare. We can use mNGS to detect M. hominis in the CSF and then provide targeted treatment.

Keywords: Neurosurgery, Central nervous system infections, Meningitis, Mycoplasma hominis, Next-generation sequencing, Case report

Core Tip: Mycoplasma meningitis after neurosurgery is relatively rare. Intracranial infections with atypical pathogens are difficult to identify. Because Mycoplasma hominis (M. hominis ) has no cell wall, it cannot be observed by Gram staining. Moreover, the difficulty of culturing M. hominis increases the challenge of clinical detection and often delays treatment. Next-generation metagenomic sequencing can be used to identify the pathogen in the early stage of the disease.