title: Fulminant Fusobacterium necrophorum meningitis in an immunocompetent adolescent.
abstract: Fusobacterium necrophorum is an anaerobic, gram-negative highly virulent bacillus, isolated from the oropharingeal cavity, the gastrointestinal tract, and the female genital tract. It is responsible of several clinical syndromes, mainly in children or adolescents, ranging from localized abscess, usually in the upper respiratory sites, to severe septicemic diseases, including meningitis. We report the fatal case of an immunocompetent male with suppurative otitis media and meningitis. Initial empiric antibiotic treatment was not effective. After the recovery of anaerobic gram-negative bacilli from blood cultures, treatment with metronidazole was started, and a rapid improvement in laboratory parameters was observed. However, the patient's clinical course was incurable because of cerebral hypertensive complications. F. necrophorum was identified as the causative agent of this metastatic and fatal infection. This case has shown the severity of infection due to F. necrophorum and, at the same time, the underestimation of anaerobic bacteria in the spectrum of etiologic agents responsible for meningitis. Only a prompt diagnosis and an adequate treatment can improve the prognosis and avoid a fatal outcome.
authors: Unit of Immunology and Infectious Disease, University Hospital Pediatric Department - Children's Hospital Bambino Gesù, Italy. andrea.finocchi@uniroma2.it
authors: Giulia
authors: G
authors: Angelino
authors: Nicoletta
authors: N
authors: Cantarutti
authors: Sara
authors: S
authors: Chiurchiù
authors: Donato
authors: D
authors: Amodio
authors: Maia
authors: M
authors: De Luca
authors: Laura
authors: L
authors: Lancella
authors: Luana
authors: L
authors: Coltella
authors: Cristina
authors: C
authors: Russo
authors: Andrea
authors: A
authors: Finocchi
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005674:Fusobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D007121:Immunocompetence; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D008795:Metronidazole / Q000627:therapeutic use*; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole