Unusual Fusobacterium Nucleatum Infection Presenting as a Liver Abscess Associated With Cephalic Vein Thrombosis

Abstract

Pyogenic liver abscesses are uncommon entities with potentially devastating consequences requiring immediate diagnosis and treatment. Fusobacterium nucleatum is an anaerobic, gram-negative oral commensal that has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. We describe a case of an 80-year-old female patient presenting with a fusobacterium liver abscess associated with thrombosis of the left cephalic vein.

Keywords: emerging pathogen; fusobacterium nucleatum; liver abscess; septic shock.

Figure 1. Axial CT images of the abdomen and pelvis w/o contrast demonstrating a solid mass within the left lobe involving segments II, III, and IV measuring 6.7 x 7.8 x 6.5 cm, which could represent primary or metastatic tumor

CT: computed tomography

Figure 2. CTA/P showing a significant interval increase in the size of the heterogeneous left liver lesion, which now measures 11.5 cm in maximal dimension as compared with 7.8 cm on the prior CT scan four days earlier

The lesion now has a more multiloculated appearance, highly suggestive of an abscess given the rapid interval change. There are new areas of hyperdensity along the inferior aspect of the lesion suggestive of areas of hemorrhage within the abscess. CTA/P: computed tomography arterial portography