Fusobacterium necrophorum sepsis with cerebral infarction

We have described the case of a 23-month-old female child in whom Fusobacterium sepsis progressed to cerebral infarction despite therapy with intravenous chloramphenicol and ampicillin. Some clinical improvement was noted upon addition of metronidazole to the treatment regimen. The child survived, but has severe neurologic sequelae. Physicians should suspect anaerobic infection in children who have signs of severe neurologic infection and in whom cultures are negative for aerobes. In selected cases, early treatment with metronidazole may be helpful.