Fusobacterium nucleatum endocarditis: a case report and literature review

Fusobacteria is anaerobic gram-negative rods, which frequently colonize the oral cavity and can rarely cause deadly diseases in humans. The two most commonly found in this group of bacteria are fusobacterium necrophorum and fusobacterium nucleatum. Only a handful of cases of endocarditis due to fusobacterium have been reported. We describe an 86-year-old male who had a recent tooth extraction presenting to the emergency department with weakness lightheadedness, and pain in his right elbow. He had a low-grade fever of 100.8°. The patient was discharged home but came back less than 24 hours with a fever of 102° and chills and again after the second discharge with sepsis of unknown origin. A week after initial blood cultures were drawn, fusobacterium nucleatum grew in one of two sets and his transesophageal echocardiogram revealed vegetation on his mitral valve. The patient was then successfully treated with a six weeks course of ampicillin-sulbactam. This case is followed by a review of the literature.