S5116 Cryptogenic Fusobacterium Liver Abscesses in Two Healthy, Young Adult Males

Introduction: Fusobacterium necrophorum and Fusobacterium nucleatum rarely are responsible for bacterial human infections. However, when Fusobacterium necrophorum causes pyogenic liver abscesses (PLAs), it is infamously found in Lemiere’s syndrome, which encompasses internal jugular vein thrombophlebitis and septicemia. This report documents 2 cases of cryptogenic Fusobacterium liver abscesses in healthy, young adult males with a history of binge drinking, but without concomitant Lemiere’s syndrome. We highlight key differences in disease severity, bacterial species, and management between the 2 cases. Case Description/Methods: Both patients lived in similar geographic regions and presented to the hospital a month apart from one another. Patient 1 was a 19-year-old White man who arrived with fever and abdominal pain. He developed bacterial metastasis with abscess formation in the right kidney, gluteal muscles, liver, and right upper lung. He received percutaneous-guided needle aspiration of the renal abscess and was discharged on intravenous antibiotics. Patient 2 was a 20-year-old African American man with similar symptoms as patient 1. He developed a singular hepatic abscess and underwent percutaneous catheter drain placement by general surgery. The drain remained in for several days, and the patient was discharged with PO antibiotics. Both patients made complete recoveries. Discussion: It is hypothesized that both infections developed in part through aspiration of oral flora secondary to alcohol intoxication. Given the similarities in patient geography and hospitalization dates coupled to its rarity, this may be a growing issue that public healthcare leaders should be aware if future cases arise. It is important to consider Fusobacterium species in pyogenic liver abscess (PLAs) in young men with alcohol use. PLA source control may play an important role even with an abscess less than 3-5 cm. Further research needs to be conducted to determine if Fusobacterium necrophorum and Fusobacterium nucleatum are associated with alcohol and/or binge drinking.