Jayasimhan Dilip, Wu Linus, Huggan Paul
Department of Medicine, Waikato Hospital, Level 2 Waiora Waikato Building, Pembroke Street, Hamilton, 3204, New Zealand.
Department of General Surgery, Waikato Hospital, Level 2 Waiora Waikato Building, Pembroke Street, Hamilton, 3204, New Zealand.
BMC Infect Dis. 2017 Jun 20;17(1):440. doi: 10.1186/s12879-017-2548-9.
Fusobacteriae are facultative anaerobic gram-negative bacilli which cause a range of invasive infections, amongst which pyogenic liver abscesses are rare. We describe a case of Fusobacterium nucleatum liver abscess and review the relevant literature.
A 51-year-old lady presented with a 4-day history of abdominal pain, diarrhoea, fever, rigors, and lethargy. Imaging revealed an abscess which was drained. Cultures of the blood and abscess aspirate grew Fusobacterium nucleatum and Prevotella pleuritidis respectively. She achieved full recovery following treatment. A MEDLINE search was undertaken using free-text and Medical Subject Headings (MeSH), keywords "Fusobacterium" and "Liver abscess". Non-English language reports and cases without confirmed growth of Fusobacterium species were excluded. Additional cases were identified by surveying the references of each report and by using the same keywords in a web-based search. Forty-eight cases were identified, 41 in men. The median age was 42.5, with an interquartile range of 33. F. nucleatum and F. necrophorum were in involved in 22 cases each, and 4 cases were not further speciated. Among cases of F. nucleatum liver abscess, nine were attributed to periodontal disease, four to lower gastrointestinal tract disease, one to Lemierre's Syndrome, and eight were considered cryptogenic. All patients treated made a full recovery. Antimicrobial treatment duration ranged from 2 weeks to 6 months with a median of 6 weeks.
Fusobacterium nucleatum is an uncommon cause of liver abscess generally associated with good clinical outcomes with contemporary medical and surgical care.
梭杆菌属是兼性厌氧革兰氏阴性杆菌，可引发一系列侵袭性感染，其中化脓性肝脓肿较为罕见。我们描述了一例具核梭杆菌肝脓肿病例并回顾相关文献。
一名51岁女性，有4天的腹痛、腹泻、发热、寒战及乏力病史。影像学检查发现一个脓肿并进行了引流。血液和脓肿抽吸物培养分别培养出具核梭杆菌和胸膜炎普雷沃菌。经治疗后她完全康复。使用自由文本和医学主题词（MeSH）在MEDLINE数据库中进行检索，关键词为“梭杆菌属”和“肝脓肿”。排除非英语语言报告及未确认梭杆菌属生长的病例。通过查阅每份报告的参考文献并在网络搜索中使用相同关键词来识别其他病例。共识别出48例病例，其中男性41例。中位年龄为42.5岁，四分位间距为33岁。具核梭杆菌和坏死梭杆菌各涉及22例，4例未进一步分类。在具核梭杆菌肝脓肿病例中，9例归因于牙周病，4例归因于下消化道疾病，1例归因于勒米尔综合征，8例被认为是隐源性的。所有接受治疗的患者均完全康复。抗菌治疗持续时间为2周至6个月，中位时间为6周。
具核梭杆菌是肝脓肿的罕见病因，在当代医疗和外科治疗下通常具有良好的临床结局。
