Multiple Brain Abscesses Caused by Fusobacterium nucleatum Treated Conservatively

Abstract

Background:Multiple brain abscesses are serious neurological problems with high mortality and disabling morbidity. The frequency is rising as a result of AIDS and the increasing number of immunocompromised patients.Case study:A 59-year-old woman developed signs and symptoms of diffuse brain dysfunction including fever and neck stiffness. A brain CT scan demonstrated nine contrast-enhancing ring-shaped lesions. Analysis of the cerebrospinal fluid using PCR-technique revealed DNA of Fusobacterium nucleatum. Conservative treatment with antibiotics was successful. The patient recovered with only mild cognitive deficits.Results:The experience of our patient and the review of the literature indicate that multiple brain abscesses due to Fusobacterium nucleatum are rare. The most probable source is oral infection.Conclusion:Multiple brain abscesses may be caused by Fusobacterium nucleatum. Cerebrospinal fluid analysis using PCR technique is helpful with diagnosis. Conservative management can be successful.

Microbiology of Odontogenic Bacteremia: beyond Endocarditis

“…Arguably, these lesions could serve as the primary infective focus for the dissemination and subsequent seeding of bacteria into an end organ site. For a majority of episodes, the absence of other detectable infective foci led researchers to conclude that the oral cavity, by default, is the primary source of infection (57,61,63,67,86,88,114,126,139). However, these studies, mainly case reports, suggest a relationship between pyogenic CNS infections and an oral origin of bacteria such as Abiotrophia spp., Dalister pneumosintes, Streptococcus intermedius, S. oralis, Streptococcus constellatus, Fusobacterium spp., F. nucleatum, Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis (57,61,63,67,86,88,114,126,139).…”

Rapid brain death caused by a cerebellar abscess with Fusobacterium nucleatum in a young man with drug abuse: a case report

“…Overall, the incidence of brain infections caused by strictly anaerobic bacteria may have been underestimated in the past, and this neglect might account for delays in diagnosis or failure to identify the causative pathogen. Albeit several reports about brain abscesses caused by Fusobacterium nucleatum report successful recovery under conservative management, delay of effective antibiotic treatment can increase the severity of disease and lethality [10,13,18]. …”

Fusobacterial head and neck infections in children

“…Fusobacterial sinusitis can lead to meningitis and brain abscesses in older children and adults [62][63][64][65]. Brain abscesses, however, occur more often secondary to periodontal disease with bloodstream infection [66,67].…”