Fulminant fusobacterium necrophorum meningitis in an immunocompetent adolescent

Giulia Angelino, Nicoletta Cantarutti, Sara Chiurchiù, Donato Amodio, Maia De Luca, Laura Lancella, Luana Coltella, Cristina Russo, Andrea Finocchi

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Abstract

Fusobacteriumnecrophorum is an anaerobic, gram-negative highly virulent bacillus, isolated from the oropharingeal cavity, the gastrointestinal tract, and the female genital tract. It is responsible of several clinical syndromes, mainly in children or adolescents, ranging from localized abscess, usually in the upper respiratory sites, to severe septicemic diseases, including meningitis. We report the fatal case of an immunocompetent male with suppurative otitis media and meningitis. Initial empiric antibiotic treatment was not effective. After the recovery of anaerobic gram-negative bacilli from blood cultures, treatment with metronidazole was started, and a rapid improvement in laboratory parameters was observed. However, the patient's clinical course was incurable because of cerebral hypertensive complications. F. necrophorum was identified as the causative agent of this metastatic and fatal infection. This case has shown the severity of infection due to F. necrophorumand, at the same time, the underestimation of anaerobic bacteria in the spectrum of etiologic agents responsible for meningitis.Only a prompt diagnosis and an adequate treatment can improve the prognosis and avoid a fatal outcome.

Original languageEnglish
Pages (from-to)703-704
Number of pages2
JournalPediatric Emergency Care
Volume28
Issue number7
DOIs
Publication statusPublished - Jul 2012

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Keywords

  • Anaerobic bacteria
  • Fusobacterium necrophorum
  • Meningitis
  • Otitis
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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