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P. micra and F. necrophorum: Hepatic Abscesses in a Healthy Soldier
Samuel Strobel1, Daniel Whitaker1, Edwin Choi1
1Family Medicine Service, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg 28310, NC, USA.
Abstract:
Parvimonas micra (P. micra) and Fusobacterium necrophorum (F. necrophorum) are two pathogens known to cause odontogenic and oropharyngeal infections. It is exceedingly rare for these bacteria to cause coinfection and even systemic infection. There is limited literature on liver abscesses and bacteremia involving P. micra. Most cases are found in elderly patients with associated gastrointestinal malignancy (24%) or laryngeal pharynx malignancy (28%). However, a substantial portion of described cases were unable to identify a source (36%). A 36-year-old, otherwise healthy male presented for fevers and chills for 2 weeks. After testing negative for initial infectious workup, including COVID-19 multiple times, he was found to have multiple liver abscesses which grew P. micra and F. necrophorum. This case highlights a rare coinfection of hepatic abscesses in an otherwise healthy young immunocompetent adult with a solitary dental caries, resulting in septic shock.
Insights
A rare coinfection of Parvimonas micra and Fusobacterium necrophorum caused liver abscesses and septic shock in a young, healthy adult. This case highlights unusual systemic infection by these oral pathogens.
Area of Science:
- Infectious Diseases
- Microbiology
- Hepatology
Background:
- Parvimonas micra (P. micra) and Fusobacterium necrophorum (F. necrophorum) are known pathogens causing oral infections.
- Systemic coinfections with these bacteria are rare, with limited literature on liver abscesses involving P. micra.
Observation:
- A 36-year-old immunocompetent male presented with prolonged fever and chills.
- Initial infectious workups, including COVID-19 tests, were negative.
- Multiple liver abscesses were discovered, yielding P. micra and F. necrophorum.
Findings:
- This case details a rare coinfection of hepatic abscesses by P. micra and F. necrophorum in a young, healthy adult.
- The infection originated from a solitary dental caries.
- The patient developed septic shock due to the coinfection.
Implications:
- Highlights the potential for P. micra and F. necrophorum to cause severe systemic infections beyond typical oropharyngeal sites.
- Suggests considering oral pathogens in unexplained liver abscesses, even in young, healthy individuals.
- Underscores the importance of dental health in preventing rare but serious systemic complications.
