Fusobacterium Septicemia with Liver and Lung Abscesses Due to Diverticulitis

Abstract

The Fusobacterium species is known for its association with septic thrombophlebitis of the internal jugular vein (Lemierre’s syndrome). Lemierre’s syndrome is associated with septic emboli to the liver and lungs, often causing multiple abscesses. We present a unique case of Fusobacterium septicemia in which the bacteria invaded the portal vein through the gastrointestinal mucosa due to diverticulitis and spread hematogenously to the liver and lungs, causing abscesses. It was treated successfully with 6 weeks of antibiotics. Physicians should be aware of this rare pathogen and suspect its presence in severe pharyngitis or culture-negative liver abscess.

Pylephlebitis Complicated by Hepatic Abscesses due to Fusobacterium Nucleatum: A Case of Lemierre's Syndrome Variant and Literature Review

“…Source control and abscess drainage with culture are recommended in cases of liver abscess to confirm etiology and guide therapy. 2,6,15 Abscess drainage was performed in 8 of the 10 cases in our review.…”

P. micra and F. necrophorum: Hepatic Abscesses in a Healthy Soldier

“…There have been reported cases of young, otherwise healthy patients getting hepatic abscesses from Fusobacterium . The most common initial symptoms described in these cases are fever, chills, and diarrhea, ranging from 3 to 14 days prior to presentation [ 8 , 13 , 15 ]. Case reports include an otherwise healthy 21-year-old male, a 54-year-old male with concomitant lung abscesses and acute diverticulitis, and a 76-year-old female with preceding Fusobacterium bacteremia [ 8 , 13 , 15 ].…”

“…The most common initial symptoms described in these cases are fever, chills, and diarrhea, ranging from 3 to 14 days prior to presentation [ 8 , 13 , 15 ]. Case reports include an otherwise healthy 21-year-old male, a 54-year-old male with concomitant lung abscesses and acute diverticulitis, and a 76-year-old female with preceding Fusobacterium bacteremia [ 8 , 13 , 15 ]. Fusobacterium is associated with periodontal disease, and one case report suggests that even routine dental cleaning can lead to Fusobacterium bacteremia and abscess formation [ 9 ].…”

“…Fusobacterium is associated with periodontal disease, and one case report suggests that even routine dental cleaning can lead to Fusobacterium bacteremia and abscess formation [ 9 ]. Fortunately in these specific case reports, each patient clinically improved after abscess drainage and antibiotic therapy [ 8 , 9 , 13 , 15 ].…”