SHM Converge Scientific Abstract ePoster Gallery-Post-Influenza Fusobacterium Infection: A Rare Cause of Jaundice

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An 18-year-old previously healthy male presented with 10 days of fever, sinus congestion, cough, right-sided headache, myalgias, diarrhea, jaundice, and periorbital swelling after recent travel to Bahia, Brazil, with ocean swimming and sushi consumption. He had tested positive for Influenza A five days earlier but received no treatment. On admission, he was febrile and tachycardic, with mild right upper quadrant tenderness and laboratory evidence of leukocytosis, elevated inflammatory markers, hyperbilirubinemia, mild transaminitis, and elevated alkaline phosphatase.<br /><br />Imaging showed right frontal scalp cellulitis with post-septal orbital involvement, sinusitis with subgaleal abscess, and an edematous gallbladder. He was started on broad-spectrum antibiotics, but persistent fevers prompted lumbar puncture, which was unrevealing. Blood cultures on hospital day four grew penicillin-sensitive Fusobacterium necrophorum. Internal jugular vein thrombosis was excluded, ruling out Lemierre syndrome.<br /><br />His fever, facial swelling, and jaundice improved over several days, and he was discharged on amoxicillin and metronidazole.<br /><br />The case highlights a rare post-influenza Fusobacterium necrophorum infection causing sinusitis, facial cellulitis, and jaundice in a young, otherwise healthy patient. F. necrophorum is an anaerobic gram-negative bacillus that is part of normal oral and upper respiratory flora, but it can cause severe invasive disease, especially in adolescents and young adults. It is classically associated with Lemierre syndrome, though it may also lead to otogenic, paranasal, and intracranial infections. Because it grows slowly and has no rapid diagnostic test, it may be missed early. This case underscores the importance of considering F. necrophorum in patients with worsening systemic illness after influenza.

Asset Subtitle

Karlyn Henderson

Meta Tag

Author List Benjamin Verplanke, Cindy Fang, Karlyn Henderson

Category Clinical Vignettes

Concept Fusobacterium necrophorum

Concept Lemierre Syndrome

Concept Blood Culture

Concept Internal Jugular Vein Thrombus

Concept Severe Infection

Distinguished Non-Finalist

Presenter Organization NYU Langone Health

Presenting Author Karlyn Henderson

Track Adult

Keywords

Fusobacterium necrophorum

post-influenza infection

sinusitis

facial cellulitis

jaundice

adolescent patient

Lemierre syndrome

bacteremia

orbital involvement

anaerobic gram-negative bacillus

Fusobacterium necrophorum

Lemierre Syndrome

Blood Culture

Internal Jugular Vein Thrombus

Severe Infection