ABSTRACT
INTRODUCTION: Fusobacterium nucleatum is an anaerobic bacillus that is part of the oral microbiota and dental pla que. This can cause local and potentially remote infections, which are exceptional in pediatrics. Ob jective: To present the case of a patient with lung injury with chest wall invasion by Fusobacterium nucleatum. CLINICAL CASE: An 11-year-old female immunocompetent patient who consulted due to a two-week history of cough, night sweats, without fever or weight loss, and increased volume at the left spleen thoracic level. There was no history of chest wall trauma or travel outside the country. Two weeks before the onset of symptoms, she was treated for dental caries. Imaging studies and CT scan showed left spleen pneumonia, which invades the pleura and the chest wall. A minimal thoracotomy was performed, releasing a thick, foul-smelling liquid. The studies for common germs and tubercu losis were negative. Hematology ruled out tumor lesions. The anaerobic study reported the develo pment of Fusobacterium nucleatum. The patient was treated with penicillin followed by amoxicillin presenting good clinical and radiological responses. The dental procedure was suspected as the cause of infection. CONCLUSIONS: Fusobacterium nucleatum can occasionally cause remote or extra-oral in fections in immunocompetent patients, such as pneumonia with chest wall invasion, therefore it is necessary to bear it in mind.
Subject(s)
Fusobacterium Infections , Fusobacterium nucleatum/isolation & purification , Pneumonia, Bacterial/microbiology , Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Child , Dental Caries/complications , Dental Caries/therapy , Female , Fusobacterium Infections/diagnostic imaging , Fusobacterium Infections/drug therapy , Fusobacterium Infections/surgery , Humans , Penicillins/therapeutic use , Pneumonia, Bacterial/diagnostic imaging , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/surgery , Thoracic Wall/microbiology , ThoracotomyABSTRACT
Se presenta una niña de 14 años con actinomicosis torácica. Se destaca la rara incidencia de esta enfermedad en la edad pediátrica y las dificultades para hacer el diagnóstico. La presencia de una lesión pulmonar de larga evolución, junto a lesiones osteomielíticas de varias costillas y posterior fistulización a la pared costal, con eliminación de los característicos "gránulos de azufre" fueron los elementos claves para sospechar la causa de la enfermedad. Se confirmó el diagnóstico por estudio bacteriológico e histológico. La paciente se trató con dosis altas de penicilina, evolucionando en forma favorable
