Abscesses of the spine and iliac fossa caused by infection with the opportunistic bacterium Fusobacterium nucleatum

We present a case of spinal and iliac fossa infection caused by Fusobacterium nucleatum in a 52-year-old male patient with unexplained back pain. Notably, the patient had no history of periodontal infections.Magnetic resonance imaging (MRI) revealed abscesses at the L3-4 vertebrae and hip, with dura mater and cauda equina compression.Next-generation sequencing (NGS) of the aspirate confirmed the presence of Fusobacterium nucleatum. The patient was treated with antibiotics (carbapenems, and metronidazole) and underwent surgical procedures for abscess drainage and internal fixation, resulting in the removal of 1000 ml of pus. Following a 46-day recovery period, the patient made a full recovery.This rare infection poses a significant diagnostic challenge due to its insidious onset and low blood culture sensitivity. The role of next-generation sequencing (NGS) in this context is paramount, as it has been instrumental in arriving at an accurate diagnosis and formulating an effective treatment plan. In view of the challenges posed by this infection, NGS emerges as a crucial tool for the diagnosis and management of unexplained infections.