Sankar J, Haribabu PPK, Singaravelu Suganya AGK. Fusobacterium brain abscess as a complication of sinusitis in an immunocompetent adolescent: A case report. World J Clin Pediatr 2026; 15(2): 114310 [DOI: 10.5409/wjcp.v15.i2.114310]
Corresponding Author of This Article
Padma Priya K Haribabu, Academic Fellow, Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, No 12 A, Nageswara Road, Tirumurthy Nagar, Nungambakkam, Chennai 600034, Tamil Nādu, India. khpadmapriya@gmail.com
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Pediatrics
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Case Report
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Jun 9, 2026 (publication date) through May 16, 2026
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World Journal of Clinical Pediatrics
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Sankar J, Haribabu PPK, Singaravelu Suganya AGK. Fusobacterium brain abscess as a complication of sinusitis in an immunocompetent adolescent: A case report. World J Clin Pediatr 2026; 15(2): 114310 [DOI: 10.5409/wjcp.v15.i2.114310]
World J Clin Pediatr. Jun 9, 2026; 15(2): 114310 Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.114310
Fusobacterium brain abscess as a complication of sinusitis in an immunocompetent adolescent: A case report
Janani Sankar, Padma Priya K Haribabu, Ajay Gokhulnathan K Singaravelu Suganya
Janani Sankar, Padma Priya K Haribabu, Ajay Gokhulnathan K Singaravelu Suganya, Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai 600034, Tamil Nadu, India
Co-first authors: Janani Sankar and Ajay Gokhulnathan K Singaravelu Suganya.
Author contributions: Sankar J contributed to conceptualization and supervision; Haribabu PPK contributed to drafting of manuscript and review of literature; Suganya AGKS contributed in collection of resource material and references.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Padma Priya K Haribabu, Academic Fellow, Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, No 12 A, Nageswara Road, Tirumurthy Nagar, Nungambakkam, Chennai 600034, Tamil Nādu, India. khpadmapriya@gmail.com
Received: September 22, 2025 Revised: October 30, 2025 Accepted: December 15, 2025 Published online: June 9, 2026 Processing time: 234 Days and 22 Hours
Abstract
BACKGROUND
Brain abscesses are uncommon intracranial infections with an estimated incidence of 0.5 per 100000 individuals. Among bacterial causes, Fusobacterium species account for less than 10% of cases, and fewer than 20 pediatric instances have been reported worldwide. These infections are predominantly seen in individuals with poor dental hygiene, sinusitis and pose diagnostic challenges due to their anaerobic nature and frequent culture negativity. However, cases in immunocompetent individuals are rare and often pose diagnostic challenges due to the anaerobic nature of the causative organisms.
CASE SUMMARY
We report a 15-year-old boy who presented with a 5-day history of fever, headache, vomiting, and altered sensorium, followed by status epilepticus. Clinical, imaging, and laboratory data were systematically collected. Magnetic resonance imaging revealed bilateral frontal and left temporal subdural abscesses with frontal sinusitis. Pus obtained during burr-hole drainage underwent conventional culture and broad-range 16S rRNA next-generation sequencing (NGS) to identify the pathogen. Initial aerobic and anaerobic cultures were sterile. NGS identified Fusobacterium nucleatum as the etiological agent. Empirical antibiotics (ceftriaxone, vancomycin, and metronidazole) were streamlined to ceftriaxone plus metronidazole after confirmation. The patient required repeat burr-hole drainage due to paradoxical effusion enlargement caused by inflammatory response following bacterial lysis. After four weeks of targeted therapy, he achieved full neurological recovery, with normalization of inflammatory markers and complete resolution on follow-up imaging.
CONCLUSION
This case underscores the diagnostic value of 16S rRNA sequencing in culture-negative brain abscesses and highlights the importance of multidisciplinary management combining surgical source control and targeted anaerobic therapy. Early recognition and appropriate treatment of sinusitis, in line with IDSA recommendations, may prevent severe complications such as Fusobacterium brain abscess.
Core Tip: Fusobacterium nucleatum brain abscess is an uncommon but serious complication of sinusitis, especially in immunocompetent children. Conventional cultures often remain sterile because of the organism’s anaerobic nature. This case illustrates the value of 16S rRNA next-generation sequencing for rapid pathogen identification and targeted therapy. Early neurosurgical drainage with appropriate anaerobic coverage resulted in full neurological recovery.
