Fusobacterium nucleatum bacteremia with liver abscess following administration of ChAdOx1nCov-19 vaccine

 A 67-year-old physician with a past history of hypertension, allergic rhinitis and hepatic hemangioma for 10 years received the first dose of ChAdOx1nCov-19 vaccine on 2021/3/22. Three days later, he presented with fever, up to 39oC, combined with general soreness. His fever subsided after a pain reliever, occurred again 9 days later and subsided again.  Neither leukocytosis nor a higher C-reactive protein (CRP) level was noted at that time, but he developed a fever again two days later and subsequently tested for significantly more elevated inflammatory markers (CRP level of 148.56 mg/L (reference range <5 mg/L) and procalcitonin C of 3.1 ng/ml (reference range <0.5 ng/mL), ALT and AST slightly elevated). His COVID-19 nasopharyngeal swab test was still negative. Both abdominal echography and computed tomography of the abdomen showed abscesses at left lateral segment of the liver. The pus smear revealed Gram-negative bacilli that was later confirmed as Fusobacterium nucleatum. 

The patient then received antibiotics with metronidazole and underwent liver abscess drainage. After 4 weeks of metronidazole treatment, the patient was able to return to his normal daily life.


REFERENCE
Wu J, Lai Y, Chiu C. Fusobacterium nucleatum bacteremia with liver abscess following administration of anti-COVID-19 vector-based vaccine. Version of January 26th 2022

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