Pyogenic Liver Abscess with Prevotella Species and Fusobacterium necrophorum as Causative Pathogens in an Immunocompetent Patient

Abstract

Pyogenic liver abscess of odontogenic origin in an immunocompetent patient is extremely rare. We report an immunocompetent 25-year-old male hepatitis B carrier with severe dental disease that led to the development of liver abscess. A periapical abscess in the upper left molar area was seen on his dental X-ray. Two sets of blood cultures grew Prevotella species, bacteria that are commonly found inside the oral cavity. Bacterial culture of the liver abscess drainage sample grew both Prevotella and Fusobacterium necrophorum. This led to our diagnosis of pyogenic liver abscess of dental origin, since we found no other source of infection in our patient except for his dental disease. After antibiotic therapy with drainage, abdominal sonography showed resolution of the abscess. The diseased teeth were also extracted. During 1 year of follow-up, there was no sign of abscess recurrence. A diagnosis of pyogenic liver abscess necessitates a complete evaluation to rule out possible biliary, colonic or other associated diseases. However, when a liver abscess is thought to be cryptogenic, we also recommend a careful dental examination to help identify the source of infection.

Two Cases of Liver Abscesses Derived from Dental Disease in Patients with Alcoholic Chronic Pancreatitis

“…A total of 11 cases of PLA derived from dental disease reported between 1987 and 2013, based on our search of PubMed (Table) (3)(4)(5)(6)(7)(8)(9). Fusobacterium and Streptococcus are reported to be major species of causative bacteria of PLA arising from dental infection and were also detected on abscess fluid cultures in our cases; these bacteria are also known to be normal oral flora.…”

A Case of Pyogenic Liver Abscess Infected with Fusobacterium necrophorum Depicted by Microscopy and Confirmed by Tissue Culture

“…All known previous reports are summarized in Ta- ble 2 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Liver abscesses in cattle from Fusobacterium necrophorum are considered to be secondary to the primary focus of infection on the ruminal wall through the portal circulation (12,26,27).…”

Antibiotic susceptibility of 33 Prevotella strains isolated from Romanian patients with abscesses in head and neck spaces

“…P. intermedia, P. nigrescens, P. pallens, P. oris) are among the most dominant and prevalent bacteria isolated from dental abscesses and their severe complications due to bacterial spreading [11,12], as: brain [13,14], liver [15] or lung abscesses [16], mediastinitis [17], necrotizing fasciitis [17,l8], Ludwig's angina [19] and sepsis [20]. In facial cellulitis of dental origin, Prevotella was reported as the most frequently isolated anaerobic bacteria [21].…”