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Fulminant Fusobacterium necrophorum meningitis in an immunocompetent adolescent

Giulia Angelino1, Nicoletta Cantarutti, Sara Chiurchiù

  • 1Unit of Immunology and Infectious Disease, University Hospital Pediatric Department - Children's Hospital Bambino Gesù, Italy. andrea.finocchi@uniroma2.it

Pediatric Emergency Care
|July 7, 2012
PubMed

Insights

Fusobacterium necrophorum, an anaerobic gram-negative bacillus, can cause severe meningitis. Prompt diagnosis and metronidazole treatment are crucial for managing this potentially fatal infection.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Neurology

Background:

  • Fusobacterium necrophorum is a virulent anaerobic, gram-negative bacillus found in the oropharynx, GI tract, and female genital tract.
  • It causes various syndromes, particularly in children and adolescents, including localized abscesses and severe septicemic diseases like meningitis.

Observation:

  • A case report details a fatal meningitis in an immunocompetent male, originating from suppurative otitis media.
  • Initial antibiotic therapy was ineffective, highlighting challenges in treating F. necrophorum infections.

Findings:

  • Blood cultures identified anaerobic gram-negative bacilli, leading to metronidazole treatment and initial laboratory improvement.
  • Despite treatment, the patient succumbed to cerebral hypertensive complications, confirming F. necrophorum as the causative agent of this metastatic infection.

Implications:

  • This case underscores the severity of F. necrophorum infections and the underestimation of anaerobic bacteria in meningitis etiology.
  • Emphasizes the critical need for prompt diagnosis and appropriate antimicrobial therapy, such as metronidazole, to improve patient outcomes.

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