Fusobacterium necrophorum Hepatic Abscess and Colorectal Cancer

Abstract

Even after identification of complications such as pulmonary embolism and infective endocarditis, with its attendant sequelae,1Volpe N Connolly S Cheema B Angarone M A curious case of endocarditis and liver abscess in a previously healthy man.Am J Med. 2019; https://doi.org/10.1016/j.amjmed.2019.07.023Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar no evaluation of hepatic abscess would be complete without documentation of its underlying cause. In some cases, the infection, which manifests itself as hepatic abscess, originates in the gastrointestinal tract, as shown by the case report of a 56-year-old man with Fusobacterium necrophorum hepatic abscess, and in whom the infection had originated from an ulcerating rectal carcinoma.2García Carretero R Lopez-Lomba M Vazquez-Gomez O Rodriguez-Maya B Bacteraemia and liver abscess due to fusobacterium necrophorum.BMJ Case Rep. 2017; 2017 (pii: bcr-2017-220654. https://doi.org/10.1136/bcr-2017-220654)Google Scholar In another report, comprising 48 cases of fusobacterial liver abscess (including 22 attributable to Fusobacterium necrophorum), 2 patients had infection that originated from hemorrhoids and diverticular disease, respectively. In both cases, the culprit pathogen was Fusobacterium necrophorum.3Jayasimhan D Wu L Huggan P Fusobacterium liver abscess: a case report and review of the literature.BMC Infect Dis. 2017; 17: 440Crossref PubMed Scopus (19) Google Scholar In a retrospective hospital-based study covering a 10-year period, there were 26 patients with a variety of fusobacterium infections, including 10 attributable to Fusobacterium necrophorum. In 2 cases of liver abscess (fusobacterium subtype not specified), the most probable primary source was thought to be “the disruption of the mucosal colonic barrier related to colorectal cancer.”4Garcia-Carretero R Lopez-Lomba M Carrasco-Fernandez B Duran-Valle MT. Clinical features and outcomes of Fusobacterium species infections in a ten-year follow-up.J Crit Care Med (Targu Mures). 2017; 3: 141-147Crossref PubMed Google Scholar In view of the above, an evaluation of the entire gastrointestinal tract should be performed in all patients with Fusobacterium necrophorum liver abscess in order to optimize the chances of identifying treatable gastrointestinal cancer as the underlying cause of the infection.