Meningitis due to Fusobacterium nucleatum after a kart crash

Primary meningitis due to Fusobacterium nucleatum successfully treated with ceftriaxone in a healthy adult male

“…The patient in the fatal case report had an extensive history of alcoholism with encephalitis and hydrocephalus complicating the clinical course and failed to respond to combination metronidazole and penicillin [7]. In all cases, the identification of the bacterium via CSF culture was delayed, likely because anaerobic cultures are generally not performed on CSF samples [[7], [8], [9], [10]]. In the current case and in three of four reported cases, patients were started on a broad empiric antimicrobial regimen for meningitis that included a third-generation cephalosporin (see Table 1) [[7], [8], [9]].…”

“…In all cases, the identification of the bacterium via CSF culture was delayed, likely because anaerobic cultures are generally not performed on CSF samples [[7], [8], [9], [10]]. In the current case and in three of four reported cases, patients were started on a broad empiric antimicrobial regimen for meningitis that included a third-generation cephalosporin (see Table 1) [[7], [8], [9]]. One case included meropenem in addition to vancomycin [10].…”

“…Most documented Fusobacterium meningitis cases occur in the pediatric population, and the majority are secondary to another infection, most commonly acute otitis media (AOM) [[1], [2], [3], [4], [5], [6]]. Three documented cases of meningitis due to Fusobacterium in adults have been reported, all of which are secondary to another primary diagnosis (AOM, spinal cord injury, and cavernous venous thrombosis) [[7], [8], [9]]. One other case described an otherwise healthy adult with meningitis due to F. necrophorum and focused on the identification of the organism through polymerase chain reaction (PCR) followed by electrospray ionization mass spectrometry [10].…”