title: Unusual neurological presentation of Fusobacterium necrophorum disease.
abstract: A 2-year-old girl presented to hospital, with reduced consciousness and fever. She had a 4-week history of fever treated with two courses of amoxicillin for tonsillitis diagnosed in primary care. Neuroimaging revealed multiple cerebral abscesses and subdural empyema. Pus aspirated from the intracranial collections grew Fusobacterium necrophorum and meropenem was started. Following neurosurgery, the patient continued to be agitated with fluctuating fever. She underwent close monitoring with regular neuroimaging. To control the progression of intracranial infection, she underwent three separate neurosurgical procedures following which she made a good recovery. This case demonstrates how an organism rarely associated with childhood illnesses presented atypically and progressed into a complex potentially fatal intracranial infection requiring a high degree of neurosurgical intervention. Awareness of this organism is important. The combination of source control together with appropriate antibiotic use was crucial in controlling the infection.
authors.affiliation: Department of Paediatric Neurology, University Hospital of Wales, Cardiff, UK.
authors.forename: Nasrean
authors.identifier: http://orcid.org/0000-0001-6744-9118
authors.initials: N
authors.lastname: Haddad
authors.affiliation: UK Anaerobe Reference Unit, Public Health Wales Microbiology, Cardiff, UK.
authors.forename: Trefor
authors.initials: T
authors.lastname: Morris
authors.affiliation: Department of Microbiology, University Hospital of Wales, Cardiff, UK.
authors.forename: Rishi
authors.initials: R
authors.lastname: Dhillon
authors.affiliation: Department of Paediatric Neurology, University Hospital of Wales, Cardiff, UK.
authors.forename: Frances
authors.initials: F
authors.lastname: Gibbon
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000382:microbiology* / Q000601:surgery; D002675:Child, Preschool; D013354:Empyema, Subdural / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005674:Fusobacterium Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D000077731:Meropenem; D013845:Thienamycins / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000658:Amoxicillin; D000077731:Meropenem