Get the facts about Fusobacterium

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A RECENT CASE REPORT describes a 57-year-old man without a significant medical history who underwent a routine dental cleaning and examination.1 His oral health was unremarkable, and no invasive dental procedures were performed. Two weeks later, he presented to the hospital with tachycardia and a low-grade fever of 100.9° F (38.3° C). He had hypoactive bowel sounds and complained of right upper quadrant tenderness. Lab tests revealed leukocytosis with bandemia (“left shift”), an indication of significant inflammation and possible infection.
After blood culture specimens were obtained, I.V. metronidazole and ceftriaxone were administered. Magnetic resonance imaging demonstrated a hepatic abscess, and the patient underwent computed tomography-guided percutaneous drainage. Thirty-five milliliters of purulent fluid was obtained and sent to the lab for culture and sensitivity, which revealed Fusobacterium necrophorum (F. necrophorum), an anaerobic Gram-negative bacterium.
After receiving the culture and sensitivity test results, antibiotic therapy was changed to metronidazole and piperacillin/tazobactam. The patient responded well and was subsequently discharged. A follow-up evaluation revealed complete resolution of the hepatic abscess. The authors speculated that the oral cleaning in the dentist's office may have resulted in mucosal trauma that allowed this organism to enter the bloodstream.
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