SHM Converge Scientific Abstract ePoster Gallery-Fusobacterium Nucleatum a Rare Cause of Liver Abscess

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This case report describes a rare pyogenic liver abscess caused by <strong>Fusobacterium nucleatum</strong> in a 79-year-old man with hypertension and hyperlipidemia. He presented with two weeks of abdominal pain and fever, along with right upper quadrant tenderness, elevated liver enzymes, hyperbilirubinemia, and leukocytosis.

Initial abdominal ultrasound suggested biliary disease with sludge, cholelithiasis, and possible acute cholecystitis. However, CT imaging revealed <strong>multiple hepatic fluid collections consistent with liver abscesses</strong>, including a large abscess in the right hepatic lobe. Three percutaneous drains were placed, and culture from the drained fluid grew <strong>F. nucleatum</strong>.

The patient was treated with <strong>intravenous ceftriaxone</strong> and <strong>oral metronidazole</strong>. Because the usual sources of F. nucleatum infection are typically <strong>oral/periodontal disease</strong> or <strong>colonic pathology</strong>, further evaluation was performed. No periodontal abscess was found on mouth examination, and colonoscopy showed only diverticulosis, making the infection <strong>cryptogenic</strong> or without an obvious source.

Follow-up CT imaging three weeks later showed <strong>resolution of the abscesses</strong>, and the patient improved clinically. He was discharged home to complete an additional two weeks of oral metronidazole.

The report highlights that F. nucleatum, a gram-negative anaerobic organism commonly associated with the oral cavity and colon, can rarely cause liver abscess even when no clear infectious source is identified. It emphasizes the importance of <strong>prompt imaging, percutaneous drainage, culture before antibiotics, and combined antibiotic therapy</strong> for successful management.

Asset Subtitle

Sinduja Sivakumar

Meta Tag

Author List Anushree Senthil, Harkesh Arora, Morgan E. MacKenzie, Padmanabhan Priyesh, Sathishkumar Ramalingam, Sinduja Sivakumar, Sivaguha Yadunath Prabhakaran

Category Clinical Vignettes

Concept Fusobacterium nucleatum

Concept Pyogenic Hepatic Abscess

Concept Cryptogenic infection

Concept Percutaneous Drainage

Concept Antibiotic Therapy

Distinguished Non-Finalist

Presenter Organization Burrell College of Osteopathic Medicine

Presenting Author Sinduja Sivakumar

Track Adult

Keywords

Fusobacterium nucleatum

pyogenic liver abscess

hepatic abscess

cryptogenic infection

percutaneous drainage

ceftriaxone

metronidazole

anaerobic bacteria

colonoscopy

oral pathology

Fusobacterium nucleatum

Pyogenic Hepatic Abscess

Cryptogenic infection

Percutaneous Drainage

Antibiotic Therapy