Clinical characteristics of fusobacterial brain abscess

We retrospectively reviewed 122 patients with culture-proven bacterial brain abscesses (BBA) at our hospital over a period of 20 years and identified seven fusobacterial brain abscess patients. Here we describe the therapeutic experience in fusobacterial BBA cases and compare the clinical features of patients with single pathogen infection between fusobacterial and non-fusobacterial brain abscesses. Fusobacterium spp. accounted for 6% of the implicated pathogens of monomicrobial BBA. All seven fusobacterial brain abscess patients contracted the infection spontaneously, and two cases had important preceding events. F. nucleatum was the commonest one of the species described. Clinical presentations and laboratory data of these seven patients were similar to those of non-fusobacterial BBA, and in these patients the diagnosis was only confirmed by positive culture results. All seven patients were successfully treated with combined surgical and antimicrobial therapy. Although the average age tends to be older and there is a higher prevalence of multiloculated brain abscesses in patients wifh this type of BBA, the therapeutic outcome can be favorable with early diagnosis and prompt treatment.