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. 2023 Jan 16;5(3):CASE22195.
doi: 10.3171/CASE22195. Print 2023 Jan 16.

Ruptured intraventricular brain abscesses due to Fusobacterium nucleatum with obstructive hydrocephalus: illustrative case

Nina Srour  1 , Audrey Demand  2 , Yi Zhang  3 , William Musick  1 , Annette Lista  1 , Jiejian Lin  4
Affiliations

Ruptured intraventricular brain abscesses due to Fusobacterium nucleatum with obstructive hydrocephalus: illustrative case

Nina Srour et al. J Neurosurg Case Lessons. .

Abstract

Background: Fusobacterium spp. are strictly anaerobic microorganisms and normal flora of the oropharyngeal, gastrointestinal, and female genital tracts. It is commonly associated with periodontal disease, pharyngitis, mastoiditis, and tonsillitis, with a tendency to abscess formation.

Observations: The authors report a case of brain abscesses complicated by ventriculitis and obstructive hydrocephalus caused by Fusobacterium nucleatum of suspected odontogenic source. While repeated bacterial cultures remained negative, the isolate was identified using bacterial sequencing.

Lessons: Empirical antimicrobial coverage for F. nucleatum should be considered in patients presenting with brain abscess. Genetic bacterial sequencing utilizing 16S ribosomal RNA molecular diagnostic testing may assist in microorganism identification to guide antimicrobial therapy.

Keywords: Fusobacterium nucleatum; brain abscess; ventriculitis.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1.
FIG. 1.
Brain CT demonstrating severe obstructive hydrocephalus secondary to ventriculitis with increasing intraventricular pus.
FIG. 2.
FIG. 2.
Brain MRI showing multiple abscesses in the frontal lobe, right parietal lobe, and left occipital lobe and the spread of infection into the ventricular system with obstructive hydrocephalus secondary to ventriculitis. PFR = perifornical region slice.
FIG. 3.
FIG. 3.
Chest CT showing a solid nodule to the right upper lobe lung area.
See this image and copyright information in PMC

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