Gardnerella vaginalis Bacteremia in Male Patients: A Case Series and Review of the Literature

Gardnerella vaginalis colonization and invasive disease of the genitourinary tract in women has been well described. In men, this organism uncommonly causes infection, and bacteremia is rare. We describe two cases of G. vaginalis bacteremia in men and present a review of the literature. Our two patients each had underlying comorbid conditions that predispose to serious bacterial infection. One presented with symptoms of urinary tract infection, the other with sepsis. Urine, cultured under usual aerobic conditions, was negative in both cases, but blood cultures after prolonged incubation yielded G. vaginalis. Treatment with antibiotics was successful in both cases. Our review of the medical literature revealed 12 previously reported cases of G. vaginalis bacteremia in men. Nearly all infections in men have originated in the genitourinary tract. Three patients had no reported history of or evidence for disease of the urinary tract, one each with endocarditis, empyema and odontogenic abscess. Isolation and identification of G. vaginalis is often delayed. Selection and duration of treatment have ranged widely in previously reported cases, likely due to the absence of reports on antibiotic susceptibility of G. vaginalis and a lack of guidance regarding effective treatment.