Clindamycin-resistant Fusobacterium varium bacteremia and decubitus ulcer infection

Bacteremia due to Fusobacterium spp. is unusual (<10% of cases of anaerobic bacteremia), and the isolation of Fusobacterium varium is especially uncommon. The most probable sources of Fusobacterium bacteremia are the respiratory, the gastrointestinal, and the genitourinary tracts. A.-M. Bourgault et al. (Clin. Infect. Dis. 25[Suppl. 2]:181-183) described 40 patients with Fusobacterium bacteremia; only 3 had Fusobacterium varium, and no one had decubitus scars as the portal of entry. In another published series (S. Henry, A. De Maria, and W. R. McCabe, Am. J. Med. 75:225-231, 1983) of 26 cases, two patients had concomitant pulmonary lesions and decubitus ulcers but there was no identification to the species level mentioned. We report a case of Fusobacterium varium bacteremia and infected sacral decubitus ulcer in an elderly patient.