Fusobacterium Bacteremia Presenting with Mesenteric Vein Thrombosis

Abstract

Background Fusobacterium species are fastidious gram-negative anaerobes that frequently colonize the human oral cavity. Portal and mesenteric thrombosis associated with Fusobacterium are case-reportable; due to the rarity of these reports. Isolated mesenteric vein thrombosis from these species is even rarer. Case presentation A 59-year-old Caucasian male presented to the emergency department with a week of back pain and malaise. A CT abdomen and pelvis demonstrated an acute/early subacute partially occlusive thrombosis of the inferior mesenteric vein. Patient was discharged the same day with apixaban 5 mg twice daily. Attempts were made by the providers to contact the patient when one of the two bottles grew Fusobacterium species, but the patient didn’t respond. Patient presented to the hospital 2 weeks later with similar complaints. Patient was treated with intravenous piperacillin-tazobactam and discharged on amoxicillin-clavulanic acid for four weeks. A follow up CT in 2 months showed resolution of the thrombus. Patient completed 3 months of anticoagulation with apixaban. Conclusion We aim to increase physicians’ awareness regarding association of Fusobacterium to thrombosis at various sites. An early treatment of this condition with antibiotics and anticoagulation can prevent complications and result in favorable outcomes.

Fusobacterium nucleatum Bacteremia Presenting as Isolated Superior Mesenteric Vein Thrombophlebitis

“…This patient was treated with piperacillin-tazobactam for F. nucleatum bacteremia associated with pylephlebitis and anticoagulation for six months [ 9 ]. The literature review also reveals a case of Fusobacterium bacteremia in a 59-year-old male who presented with back pain and was found to have acute inferior mesenteric vein thrombosis [ 10 ]. However, the authors describe Fusobacterium bacteremia without specifying a particular species.…”