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Liver Abscess Due to Fusobacterium necrophorum in an Immunocompetent Patient: A Case Report and Review of the Literature

Monno, Rosa BS*; Fumarola, Luciana BS*; De Vito, Danila MD*; Gramiccia, Marina MD†; Altamura, Mauro MD‡; Giannelli, Giorgia MD‡; Monno, Laura MD‡

Infectious Diseases in Clinical Practice: November 2011 - Volume 19 - Issue 6 - pp 395-398
doi: 10.1097/IPC.0b013e3182294d32
Review Articles

We report a case of hepatic abscess in an immunocompetent patient due to Fusobacterium necrophorum possibly secondary to Lemierre syndrome. On admission, hepatomegaly was evident. Abdominal ultrasonography revealed a low-density lesion at the VII hepatic segment confirmed by computed tomography. A sample of drained fluid grew a strain of F. necrophorum, whereas blood culture were negative both for aerobic and anaerobic bacteria. Therapy with metronidazole improved both symptoms and radiographic images. Many cases of anaerobic hepatic abscess may be missed owing to difficulties in the isolation of anaerobes in many laboratories. Microbiology laboratory staff should be familiar with this microorganism. An early alert to physicians could avert delays in reaching diagnosis and specific therapy.

In case of liver abscess, the physician must look at the likely source of infection. Treatment of this source may prevent this potentially life-threatening complications. A rapid diagnosis will come from a strong collaboration between the laboratory and clinicians.

From the *Department of Odontostomatology and Surgery, University of Bari, Policlinico, Bari; †Unit of Vector-borne Diseases and International Health, Istituto Superiore di Sanità, Rome; and ‡Clinic of Infectious Diseases, University of Bari, Bari, Italy.

Correspondence to: Rosa Monno, BS, Department of Odontostomatology and Surgery, University of Bari, Policlinico, P.zza G. Cesare 11, 70124 Bari, Italy. E-mail: r.monno@igiene-seconda.uniba.it.

The authors have no funding or conflicts of interest to disclose.

This work is original and has not been published elsewhere.

Written informed consent was obtained from the patient for publication of this case report.

© 2011 Lippincott Williams & Wilkins, Inc.