Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Brain abscess due to Fusobacterium necrophorum in a patient with convulsion and no signs of meningitis

Mitsuteru Shimohata, M.D., Ph.D.1), Satoshi Naruse, M.D., Ph.D.1)2), Satoshi Kawasaki, M.D., Ph.D.3), Yumiko Watanabe, M.D.1), Miyako Koyama, M.D.4), Yasushi Ito, M.D., Ph.D.4) and Hajime Tanaka, M.D., Ph.D1)

1)Department of Neurology, Shinrakuen Hospital
2)Department of Neurology, Midori Hospital
3)Department of Respirology, Shinrakuen Hospital
4)Department of Neurosurgery, Shinrakuen Hospital

Here, we report brain abscess due to Fusobacterium necrophorum (F. necrophorum) in a 78-year-old healthy man. He developed convulsion and did not have any signs of meningitis. Although the brain magnetic resonance imaging findings of the left occipital lobe were typical of a brain abscess, his cerebrospinal fluid examination revealed only slight pleocytosis and mild increase in protein levels. Thus, it was difficult to rule out the possibility of metastatic brain tumor; the patient's condition was provisionally diagnosed as symptomatic epilepsy secondary to brain abscess. His convulsion disappeared soon after administration of antiepileptic, antibacterial, and steroid agents. A craniotomy was performed to evacuate the abscess, and F. necrophorum was identified by culturing the abscess contents. After the operation, he was treated with appropriate antibacterial agents, which resulted in resolution of the brain abscess. Although Fusobacterium species are gram-negative anaerobic bacilli commensal of the human oropharynx, we need to recognize that Fusobacterium species can be a primary pathogen causing brain abscesses and may leave residual neurological sequelae without early appropriate treatment.
Full Text of this Article in Japanese PDF (382K)

(CLINICA NEUROL, 52: 429－432, 2012)
key words: brain abscess, convulsion, gram-negative anaerobic bacillus, Fusobacterium species, Fusobacterium necrophorum

(Received: 9-Nov-11)