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Feenstra E, Van Roest A, Boes J, Spiritus T, Kenis S, Duval ELIM, Vanden Bossche S, Vanden Driessche K, Jorens PG. A Pediatric Case of Fusobacterium necrophorum Mastoiditis and Meningitis Case Report in a Healthy Child and Review of the Literature. Case Rep Pediatr 2024; 2024:6365796. [PMID: 38939326 PMCID: PMC11208823 DOI: 10.1155/2024/6365796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/02/2023] [Accepted: 04/12/2024] [Indexed: 06/29/2024] Open
Abstract
In infants and children, bacterial meningitis caused by anaerobic bacteria is rare. However, a serious infection with the anaerobe Fusobacterium necrophorum can occur in previously healthy children with a peak incidence in preschool children and in adolescents. As the clinical presentation can be very similar to meningitis caused by aerobic bacteria, one should consider Fusobacterium necrophorum as the causative agent when preceded by or associated with otitis media with purulent otorrhea or mastoiditis, in combination with minimal or no improvement on empiric antibiotic treatment. As this pathogen can be difficult to culture, anaerobic cultures should be obtained. Prompt treatment with a third-generation cephalosporin and metronidazole should be initiated once suspected or confirmed. Surgical source control is often necessary, but even with adequate and prompt treatment, the morbidity and mortality in children with a Fusobacterium necrophorum meningitis remains high. In this report, we describe a case of Fusobacterium necrophorum meningitis in a previously healthy child and review the available literature.
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Affiliation(s)
- Elizabeth Feenstra
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Aalt Van Roest
- Pediatrics and Microbiology, AZ Turnhout, Turnhout, Belgium
| | - Juul Boes
- Pediatrics and Microbiology, AZ Turnhout, Turnhout, Belgium
| | - Tom Spiritus
- Pediatrics and Microbiology, AZ Turnhout, Turnhout, Belgium
| | - Sandra Kenis
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Els L. I. M. Duval
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Antwerp, Belgium
| | - Stephanie Vanden Bossche
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Koen Vanden Driessche
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Philippe G. Jorens
- Pediatrics, (Pediatric) Critical Care, Pediatric Neurology, Radiology, General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Antwerp, Belgium
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Hintze T, Steed M, Sievers E, Bagwell JT, Selfa N. Primary meningitis due to Fusobacterium nucleatum successfully treated with ceftriaxone in a healthy adult male. IDCases 2019; 18:e00616. [PMID: 31453104 PMCID: PMC6704266 DOI: 10.1016/j.idcr.2019.e00616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/03/2019] [Accepted: 08/03/2019] [Indexed: 11/29/2022] Open
Abstract
Fusobacterium nucleatum is a rod-shaped gram-negative obligate anaerobe; this organism, and other anaerobes, are usually not a part of the culture performed for a cerebrospinal fluid (CSF) sample. To date, four cases of Fusobacterium meningitis in adults have been published. We report successful treatment of a case of primary meningitis due to Fusobacterium nucleatum in an otherwise healthy 72-year-old male.
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Affiliation(s)
- Trager Hintze
- Department of Pharmacy Practice, The University of Oklahoma College of Pharmacy, 1110 N. Stonewall Ave., Oklahoma City, OK, 73117, USA
- Corresponding author.
| | - Michelle Steed
- Department of Pharmacy Practice, Idaho State University College of Pharmacy, 921 S. 8th Ave, Stop 8333, Pocatello, ID, 83209-8333, USA
- Department of Pharmacy, Eastern Idaho Regional Medical Center, 3100 Channing Way, Idaho Falls, ID, 83404, USA
| | - Eric Sievers
- Department of Pharmacy, Eastern Idaho Regional Medical Center, 3100 Channing Way, Idaho Falls, ID, 83404, USA
| | - John T. Bagwell
- Department of Medicine, Eastern Idaho Regional Medical Center, 3100 Channing Way, Idaho Falls, ID, 83404, USA
| | - Nicola Selfa
- Department of Microbiology, Eastern Idaho Regional Medical Center, 3100 Channing Way, Idaho Falls, ID, 83404, USA
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Ko JH, Baek JY, Kang CI, Lee WJ, Lee JY, Cho SY, Ha YE, Kim SH, Chung DR, Peck KR, Lee NY, Song JH. Bacteremic meningitis caused by Parvimonas micra in an immunocompetent host. Anaerobe 2015; 34:161-3. [PMID: 25977161 DOI: 10.1016/j.anaerobe.2015.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/25/2015] [Accepted: 05/04/2015] [Indexed: 12/17/2022]
Abstract
A 61-year-old man with chronic hepatitis B and dyslipidemia visited the emergency department with a fever and severe headache. He was diagnosed with bacterial meningitis after a lumbar puncture, and blood culture revealed Parvimonas micra bacteremia. Although he had a history of extraction of a molar two weeks before symptom onset, there was no evidence of abscess formation on physical examination or imaging studies. He was successfully treated with oral metronidazole for 12 days after 9 days of treatment with IV ceftriaxone and vancomcycin. This is the first report of primary bacterial meningitis caused by this organism, which indicates that this organism is capable of being a bacterial meningitis pathogen.
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Affiliation(s)
- Jae-Hoon Ko
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Jin Yang Baek
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
| | - Woo Joo Lee
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Ji Yong Lee
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Young Eun Ha
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - So Hyun Kim
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hoon Song
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
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