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Fusobacterium nucleatum: a rare cause of pyogenic liver abscess

Sajan Jiv Singh Nagpal1, Dhruvika Mukhija1, Preethi Patel2

  • 1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH 44195 USA.

Springerplus
|June 24, 2015
PubMed

Insights

Pyogenic liver abscesses are rare but serious infections. This case highlights Fusobacterium nucleatum, often linked to poor oral hygiene, as a rare cause in immunocompetent individuals.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Pyogenic liver abscesses (PLAs) are uncommon but carry high mortality and morbidity.
  • Most PLAs are polymicrobial, typically involving enteric bacteria and anaerobes.
  • Monomicrobial infections are rare, usually occurring in immunocompromised patients.

Purpose of the Study:

  • To report an unusual case of a PLA caused by Fusobacterium nucleatum in an immunocompetent patient.
  • To emphasize the potential role of dental sources and poor oropharyngeal hygiene in F. nucleatum-associated PLAs.
  • To highlight F. nucleatum as a differential diagnosis for PLAs, particularly in patients with specific risk factors.

Main Methods:

  • Case report of a 69-year-old immunocompetent female.
  • Clinical presentation, diagnostic workup, and treatment of the pyogenic liver abscess.
  • Identification of Fusobacterium nucleatum as the causative agent.

Main Results:

  • The patient, an immunocompetent 69-year-old female, developed a PLA.
  • Fusobacterium nucleatum was identified as the sole causative organism.
  • A likely dental source and poor oropharyngeal hygiene were implicated.

Conclusions:

  • Fusobacterium nucleatum can cause pyogenic liver abscesses even in immunocompetent individuals.
  • Poor oropharyngeal hygiene is a significant risk factor for F. nucleatum infections.
  • F. nucleatum should be considered in the differential diagnosis of PLAs, especially in patients with compromised oral health. Treatment involves abscess drainage and antibiotics.
Keywords:
FusobacteriumImmunocompromised statePoor dental hygienePyogenic liver abscess

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