Bacteraemia and multiple liver abscesses due to Fusobacterium nucleatum in a patient with oropharyngeal malignancy

Area of Science:

• Microbiology
• Infectious Diseases
• Oncology

Background:

• Fusobacterium species are commensal bacteria in the oropharyngeal cavity and digestive tract.
• Disruption of mucosal barriers, especially in immunocompromised individuals or those with malignancy, can lead to invasive Fusobacterium infections.
• These infections present a wide clinical spectrum, from mild conditions to severe sepsis and abscesses.

Observation:

• An elderly female patient presented with lethargy and altered consciousness.
• Diagnostic workup revealed a posterior oral cavity tumor (squamous cell carcinoma).
• The patient was diagnosed with Fusobacterium nucleatum bacteremia and liver abscesses.

Findings:

• The patient exhibited severe sepsis secondary to Fusobacterium nucleatum bacteremia and liver abscesses.
• Despite prompt referral to the intensive care unit and administration of antibiotic treatment, the patient's condition deteriorated.
• The patient ultimately succumbed to the infection.

Implications:

• This case highlights the critical role of Fusobacterium nucleatum in severe opportunistic infections, particularly in cancer patients.
• It underscores the potential for rapid progression to sepsis and multi-organ involvement.
• Early recognition of predisposing factors and prompt, aggressive management are crucial, though outcomes can still be poor in severe cases.