Fulminant Sepsis and Perinatal Death at 23 Weeks Due to Fusobacterium nucleatum

Abstract

Introduction: Fusobacterium nucleatum is a gram-negative anaerobe, a constituent of the oral microflora, responsible for chronic periodontal diseases. Case Report: We describe a preterm infant with premature rupture of membranes at 23 weeks of gestational age due to F. nucleatum. The newborn died soon after birth. Placental histopathology showed severe necrotizing chorioamnionitis and funisitis with gram-negative bacilli. After autopsy, F. nucleatum was microbiologically isolated from the lung. The mother had dental hygiene 1 day before delivery, presenting mild and diffuse gingivitis. At admission, she had leukocytosis, foul-smelling vaginal discharge, but no fever. Conclusion: This case highlights the possibility of F. nucleatum spreading from oral cavity after a dental procedure to the placenta with chorioamnionitis and fetal infection. This raises the question of whether dental procedures during pregnancy should be accompanied by prophylactic antibiotics.

Keywords:

• Fusobacterium nucleatum
• periodontal disease
• preterm premature rupture of membranes
• chorioamnionitis

Author contributions

M.P.B. wrote the manuscript and provided the histological diagnosis; G.C. and M.P. clinically managed the patient; M.B., G.R., and Ed.Ca. carried out the microbiological diagnosis; G.D.D. searched for the bibliography; A.P. provided the histological pictures; G.B. collected clinical information; El.Ch. and G.G. clinically managed the newborn. All authors approved the final version of the manuscript.

Informed consent statement

Our investigations were carried out following the rules of the Declaration of Helsinki of 1975, revised in 2013. The current Italian legislation neither requires the family’s consent or ethical approval for a single case, as long as the data are strictly kept anonymous, according to the Italian Authority of Privacy and Data Protection (“Garante della Privacy”: GDPR nr 679/2016; 9/2016 and recent law addition number 424/19th of July 2018; http://www.garanteprivacy.it).

Disclosure statement

The authors declare no competing interest.

Funding

The author(s) reported there is no funding associated with the work featured in this article.