Abdominal surgical‐site Fusobacterium nucleatum pyomyositis in an immunocompetent adolescent

• Published in: The Kaohsiung journal of medical sciences 2022-08, Vol.38 (8), p.808-809
• Main Authors: Tai, Chao‐Ting, Lee, Min‐Sheng, Chang, Yu‐Tang
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal surgery; Abscesses; Conflicts of interest; Immunocompetence; Infections; Patients; Surgery
• ISSN: 1607-551X; 2410-8650
• DOI: 10.1002/kjm2.12562

(B) Note two pigtail catheters and previous operative scar (red arrow) at right lower abdomen, which is compatible with the location of pyomyositis. Because of continuing fever and abdominal pain, surgical drainage was later performed with simultaneous laparoscopic examination showing no intraperitoneal spillage of abscess, but severe adhesion of omentum to the peritoneum over the right lower quadrant of the abdomen was found (Figure 1). [...]the weakened muscle could then offer little resistance to microorganisms. The cause of pyomyositis is generally regarded as the result of hematogenous spread of infection from an occult source. 2 In our case, the blood cultures showed no bacterial growth, but the pus cultures grew F. nucleatum, which is a commensal flora in the human oral cavity and plays an important role in oral hygiene and periodontal disease. 3 This patient had undergone dental caries treatment 2 months earlier, so it is reasonable to hypothesize that the hematogenous spread of F. nucleatum was due to weakening of the abdominal muscles resulting from previous abdominal surgery as the possible cause of infection.