Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2018; 6(16): 1169-1174
Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1169
Spontaneous cerebral abscess due to Bacillus subtilis in an immunocompetent male patient: A case report and review of literature
Ioannis Tsonis, Lydia Karamani, Panagiota Xaplanteri, Fevronia Kolonitsiou, Petros Zampakis, Georgios Gatzounis, Markos Marangos, Stelios F Assimakopoulos
Ioannis Tsonis, Lydia Karamani, Georgios Gatzounis, Department of Neurosurgery, University of Patras Medical School, Patras 26504, Greece
Panagiota Xaplanteri, Fevronia Kolonitsiou, Department of Microbiology, University of Patras Medical School, Patras 26504, Greece
Petros Zampakis, Department of Radiology, University of Patras Medical School, Patras 26504, Greece
Markos Marangos, Stelios F Assimakopoulos, Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras 26504, Greece
Author contributions: Tsonis I and Gatzounis G were the patient’s neurosurgeons, reviewed the literature and contributed to manuscript drafting; Karamani L reviewed the literature and contributed to manuscript drafting; Xaplanteri P and Kolonitsiou F performed the microbiological analyses and interpretation and contributed to manuscript drafting; Zampakis P analyzed and interpreted the imaging findings; Marangos M and Assimakopoulos SF performed the infectious diseases consultation, reviewed the literature and drafted the manuscript; Assimakopoulos SF, Marangos M and Gatzounis G were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
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 conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Stelios F Assimakopoulos, MD, PhD, Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras 26504, Greece. sassim@upatras.gr
Telephone: +30-2610-999583 Fax: +30-2610-993982
Received: October 4, 2018
Peer-review started: October 4, 2018
First decision: October 25, 2018
Revised: October 30, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 26, 2018
Core Tip

Core tip: Bacillus subtilis (B. subtilis) is considered a non-pathogenic microorganism of the genus Bacillus and a common laboratory contaminant. We present herein, a rare case of spontaneous cerebral abscess caused by B. subtilis, evolved in a previously healthy immunocompetent male patient. B. subtilis was isolated from both the capsule and pus of the surgically excised brain abscess. Severe tooth decay and periodontitis were the only potential infectious foci. This case highlights the ultimate importance of appropriate oral hygiene and dental care to avoid potentially serious infectious complications and second, B. subtilis should not be considered merely as laboratory contaminant especially when cultivated by appropriate central nervous system specimen.