A young man with empyema: A report of isolated fusobacterial disease

Fusobacterial disease has been increasingly noted as a cause of acute pharyngitis in adolescents. Fusobacterium necrophorum is most commonly associated with Lemierre syndrome. Isolated empyema without Lemierre syndrome is a rare consequence of F. necrophorum.A 26-year-old African American man with no contributory medical history presented with a 1-week history of dyspnea and fevers having recently undergone a routine dental cleaning. He was found to have large bilateral empyemas. The anaerobic culture of the pleural fluid grew F. necrophorum.Fusobacterium necrophorum remains a rare disease in humans, accounting for less than 1% of all human bacteremias and rarely described in the literature since its discovery. Although pleural disease has been seen in association with Lemierre syndrome, F. necrophorum is a rare cause of isolated empyema without concurrent Lemierre syndrome. Risk factors for pleuropulmonary disease include periodontitis, recent dental procedure, chronic aspiration, and older age.