Term stillbirth caused by oral Fusobacterium nucleatum

Abstract

Background: Intrauterine infection is a recognized cause of adverse pregnancy outcome, but the source of infection is often undetermined. We report a case of stillbirth caused by Fusobacterium nucleatum that originated in the mother's mouth.

Case: A woman with pregnancy-associated gingivitis experienced an upper respiratory tract infection at term, followed by stillbirth a few days later. F. nucleatum was isolated from the placenta and the fetus. Examination of different microbial floras from the mother identified the same clone in her subgingival plaque but not in the supragingival plaque, vagina, or rectum.

Conclusion: F. nucleatum may have translocated from the mother's mouth to the uterus when the immune system was weakened during the respiratory infection. This case sheds light on patient management for those with pregnancy-associated gingivitis.

Figure 1

Accentuated decidual inflammatory response in acute chorioamnionitis caused by Fusobacterium nucleatum. (A) Decidua capsularis (hemotoxylin and eosin [H&E] stain, 200× magnification): There is an unusually extensive and intense neutrophilic infiltrate in the decidua capsularis (arrow). (B) Decidua basalis (H&E, 200× magnification): Focus of acute deciduitis in the decidua basalis underlying the intervillous space (arrow). These foci are rarely seen in typical cases of acute chorioamnionitis.

Figure 1

Accentuated decidual inflammatory response in acute chorioamnionitis caused by Fusobacterium nucleatum. (A) Decidua capsularis (hemotoxylin and eosin [H&E] stain, 200× magnification): There is an unusually extensive and intense neutrophilic infiltrate in the decidua capsularis (arrow). (B) Decidua basalis (H&E, 200× magnification): Focus of acute deciduitis in the decidua basalis underlying the intervillous space (arrow). These foci are rarely seen in typical cases of acute chorioamnionitis.