Multiple Fusobacterium nucleatum liver abscesses. Association with a persistent abnormality in humoral immune...

A previously healthy 29-year-old man developed multiple hepatic abscesses secondary to Fusobacterium nucleatum. No underlying local disease was found. The leading portal of entry for the bacterium may have been the oral cavity; 4 days before the onset of his illness he had had extensive dental work. Immunological evaluation during the illness and in late convalescence (16 weeks after onset) revealed a persistent B cell abnormality characterized by markedly depressed in vitro secretion of immunoglobulins in response to pokeweed mitogen; however, serum immunoglobulins and IgG subclasses were normal. Abnormal numbers of suppressor T cells (OKT8+) and increased suppressor function were also present. Anaerobic pyogenic liver abscesses may occur in the absence of obvious underlying disease, but this case suggests that there may be an association with in vitro abnormalities of the immune system.