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Case report
Concurrent fusobacterial pyogenic liver abscess and empyema
  1. Ahmed Gohar1,
  2. Fady Jamous1,2 and
  3. Mohamed Abdallah1
  1. 1Department of Internal Medicine, Univesity of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA
  2. 2Department of Pulmonary & Sleep Medicine, Avera Medical Group, Sioux Falls, SD, USA
  1. Correspondence to Dr Ahmed Gohar; dr.ahmedgohar{at}


We present a very rare case of concurrent empyema and liver abscess caused by Fusobacterium. Our patient presented with 3-month history of subtle abdominal discomfort and cough leading to eventually presenting with marked chest pain, dyspnoea and septic shock. CT revealed a liver abscess and large right-sided pleural effusion. Drainage of the pleural effusion yielded gross pus with the growth of Fusobacterium varium, while drainage of the liver abscess yielded Fusobacterium nucleatum. The patient responded to drainage and antibiotic therapy with resolution of symptoms and decrease in the size of empyema and abscess on follow-up imaging. We also include a review if literature of related fusobacterial infections.

  • liver disease
  • intensive care
  • infectious diseases
  • respiratory medicine

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  • Contributors AG: literature review, interpretation of the data, drafting of the introduction, case presentation and discussion section. FJ: clinical care of the patient, interpretation of the data, conceptual development of the paper, coordination of the writers, revising the work for important intellectual content. MA: drafting of the summary and learning points sections, interpretation of the data and critically revising the work for important intellectual content. All authors made substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.