A Case of Liver Abscess Caused by Fusobacterium nucleatum in a Patient with Recurrent Periodontal Diseases

Yong Hwan Kim; Hee Jung Yoon; Chan Woong Park; Jung Ho Kim; Min Kyung Lee; Ki Bang Kim; Dong Jib Na; Ji Myung Kim

doi:10.4166/kjg.2011.57.1.42

Journal List > Korean J Gastroenterol > v.57(1) > 1006832

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Kim, Yoon, Park, Kim, Lee, Kim, Na, and Kim: A Case of Liver Abscess Caused by Fusobacterium nucleatum in a Patient with Recurrent Periodontal Diseases

Case Report

Korean J Gastroenterol 2011;57(1):42-46.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.1.42

A Case of Liver Abscess Caused by Fusobacterium nucleatum in a Patient with Recurrent Periodontal Diseases

Yong Hwan Kim, Hee Jung Yoon, Chan Woong Park, Jung Ho Kim, Min Kyung Lee, Ki Bang Kim, Dong Jib Na, Ji Myung Kim¹

Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea

¹Department of Laboratory Medicine, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea

Correspondence to: Hee Jung Yoon, Division of Infectious Diseases, Department of Internal Medicine, Eulji University College of Medicine, 1306, Dunsan-dong, Daejeon 302-799, Korea. Tel: +82-42-611-3096, Fax: +82-42-611-3853, E-mail: yhj822@medimail.co.kr

Received 25 June 2010 Revised 27 August 2010 Accepted 9 September 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2×6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.

Keywords: Liver abscess, Fusobacterium nucleatum, Periodontal diseases

References

1. Chen W, Chen CH, Chiu KL, et al. Clinical outcome and prognostic factors of patients with pyogenic liver abscess requiring intensive care. Crit Care Med. 2008; 36:1184–1188.

2. Chu KM, Fan ST, Lai EC, Lo CM, Wong J. Pyogenic liver abscess. An audit of experience over the past decade. Arch Surg. 1996; 131:148–152.

3. Rubin RH, Swartz MN, Malt R. Hepatic abscess: changes in clinical, bacteriologic and therapeutic aspects. Am J Med. 1974; 57:601–610.

4. Pitt HA, Zuidema GD. Factors influencing mortality in the treatment of pyogenic hepatic abscess. Surg Gynecol Obstet. 1975; 140:228–234.

5. Greenstein AJ, Lowenthal D, Hammer GS, Schaffner F, Aufses AH Jr. Continuing changing patterns of disease in pyogenic liver abscess: a study of 38 patients. Am J Gastroenterol. 1984; 79:217–226.

6. Bourgault AM, Lamothe F, Dolcé P, Saint-Jean L, Saint-Antoine P. Fusobacterium bacteremia: clinical experience with 40 cases. Clin Infect Dis. 1997; 25(Suppl 2):S181–183.

7. Etienne M, Gueit I, Abboud P, Pons JL, Jacquot S, Caron F. Fusobacterium nucleatum hepatic abscess with pylephlebitis associated with idiopathic CD4(+) T lympho-cytopenia. Clin Infect Dis. 2001; 32:326–328.

8. Wie SH, Chang UI, Kim JD, et al. Clinical features of 141 cases of pyogenic liver abscess over a 10-year period and antibiotic sensitivity to the causative organisms. Infect Chemother. 2008; 40:199–206.

9. Nah BK, Kim YS, Moon HS, et al. Recent changes of organism and treatment in pyogenic liver abscess. Korean J Hepatol. 2003; 9:275–283.

10. Wang JH, Liu YC, Lee SS, et al. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis. 1998; 26:1434–1438.

11. Kurland JE, Brann OS. Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep. 2004; 6:273–279.

12. Infectious Diseases Society of Taiwan; Taiwan Surgical Society of Gastroenterology. Medical Foundation in Memory of Dr. Deh-Lin Cheng. Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education. CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines. Guidelines for anti-microbial therapy of intraabdominal infections in adults. J Microbiol Immunol Infect. 2008; 41:279–281.

13. Sabbaj J, Sutter VL, Finegold SM. Anaerobic pyogenic liver abscess. Ann Intern Med. 1972; 77:627–638.

14. Yoo HM, Kim WH, Yim DS, Kang JK, Park IS, Choi HJ. A clinical study on pyogenic liver abscesses. Korean J Gastroenterol. 1992; 24:1347–1361.

15. Lee OJ, Kim YC. A clinical study on liver abscess. Korean J Gastroenterol. 1994; 26:506–520.

16. Kajiya T, Uemura T, Kajiya M, et al. Pyogenic liver abscess related to dental disease in an immunocompetent host. Intern Med. 2008; 47:675–678.

17. Bennett KW, Eley A. Fusobacteria: new taxonomy and related diseases. J Med Microbiol. 1993; 39:246–254.

18. Appelbaum PC, Spangler SK, Jacobs MR. Beta-lactamase production and susceptibilities to amoxicillin, amoxicillin-clavulanate, ticarcillin, ticarcillin-clavulanate, ce-foxitin, imipenem, and metronidazole of 320 non-Bacter-oides fragilis Bacteroides isolates and 129 fusobacteria from 28 U.S. centers. Antimicrob Agents Chemother. 1990; 34:1546–1550.

19. Hecht DW. Prevalence of antibiotic resistance in anaerobic bacteria: worrisome developments. Clin Infect Dis. 2004; 39:92–97.

Fig. 1.

Abdominal CT scan showed a 8.2×6 cm mass with central low density in the right hepatic lobe.

Fig. 2.

Microscopic findings showed Fusobacterium nucleatum, long and slender gram negative bacilli (Gram stain, ×1,000).

Fig. 3.

Follow-up abdominal CT scan showed a decreased size of liver abscess (2.8×2.5 cm) in the segment 7 and 8 of the right lobe 2 weeks later after discharge.

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