Meningitis due to Fusobacterium necrophorum in an adult.
BACKGROUND
Fusobacterium necrophorum may cause a number of clinical syndromes, collectively known as necrobacillosis. Meningitis is a significant cause of mortality, rarely reported in the adult population.


METHODS
We report a fatal case of meningitis, caused by Fusobacterium necrophorum, secondary to otitis media in an alcoholic male. Diagnosis was delayed due to the typical slow growth of the organism. The clinical course was complicated by encephalitis and by hydrocephalus. The patient failed to respond to metronidazole and penicillin. The patient died on day 12 from increased intracranial pressure and brain stem infarction.


CONCLUSIONS
This case emphasizes the need for a high index of clinical suspicion to make the diagnosis of Fusobacterium necrophorum meningitis. We recommend the use of appropriate anaerobic culture techniques and antimicrobial coverage for anaerobic organisms when the gram stain shows gram negative bacilli.
Department of Internal Medicine, Wright State University School of Medicine, Dayton, Ohio 45409, USA. sngarimetta@hotmail.com
SreeNeelima
S
Garimella
Aparna
A
Inaparthy
Thomas
T
Herchline
D001921:Brain / Q000473:pathology; D017809:Fatal Outcome; D005674:Fusobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy; D005675:Fusobacterium necrophorum; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy / Q000382:microbiology