Uterine Necrosis Associated withFusobacterium necrophorumInfection

Abstract

Fusobacterium necrophorum is infrequently implicated as a pathogenic organism. When pathogenic, the typical clinical presentation is that of pharyngitis, cervical adenopathy, and unilateral thrombophlebitis of the internal jugular vein. Infections caused by Fusobacterium necrophorum within the fields of obstetrics and gynecology have been infrequently reported. We describe a 19-year-old woman who underwent a cesarean delivery complicated by sepsis and purulent uterine necrosis secondary to Fusobacterium necrophorum infection.

Fusobacterium Necrophorum Septicemia Secondary to an Ovarian Abscess: A Case Report

“…To diagnose invasive F. necrophorum , anaerobic blood cultures should be obtained. Gram staining will most likely show a short coccobacillus with an occasional long filamentous form [ 7 ]. However, cultures of Fusobacterium can take up to five to eight days to grow [ 8 ].…”

“…Treatment for F. necrophorum is typically prolonged. F. necrophorum responds well to anaerobic antibiotics such as metronidazole, amoxicillin-clavulanate, clindamycin, or cefoxitin [ 7 ]. Intravenous antibiotics are recommended until the patient's fever subsides or neck swelling resolves with up to an additional four weeks of oral therapy [ 7 ].…”

“…The mortality rate from F. necrophorum infections can be high [ 1 ]. With pulmonary involvement being the most common metastatic presentation, it is important to obtain repeat chest CTs for early detection and drainage of severe complications such as empyema and effusions [ 7 ]. Another important consideration is surgical drainage of abscesses or fluid collections.…”

“…To the best of our knowledge, this patient presentation is an exceedingly rare presentation of F. necrophorum septicemia. Gynecological infections due to F. necrophorum infection are exceedingly rare and are most often associated with obstetric procedures leading to tubo-ovarian abscess or uterine abscess [ 4 , 7 ]. In our review of case reports, there is a report of salpingitis, left internal iliac vein thrombosis, septic pulmonary emboli, and F. necrophorum bacteremia after first sexual intercourse [ 9 ].…”

An atypical presentation of lemierre syndrome of urogenital source

“…Various atypical presentations of Lemierre syndrome have been described as case studies in the literature, including one here of an infection likely of gastrointestinal source (colonic bleed) [5] . Several cases have been reported of the female urogenital tract as the source including: a postcoital wound [6] ; an intrauterine device related endometritis from F. necrophorum [7] ; uterine necrosis in setting of caesarian section [8] . A more recent case was published of a 28-year-old female with pelvic peritonitis without thrombophlebitis due to F. necrophorum , however of unclear source [9] .…”