{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:17:03Z","timestamp":1793121423330,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>Brain abscess originates from a localized cerebritis area of brain parenchyma, remaining a refractory infectious disease in the central nervous system. Causative pathogens can be wide-ranging, including bacteria, fungi, or parasites; thus, precise pathogen identification and individualized antimicrobial therapy determine patients\u2019 outcomes. Here, we report two cases where both patients only presented with limb dysfunction, but without symptoms, signs, or biological evidence of infection. Samples were obtained through brain stereoscopic surgeries and microbial identifications were performed to confirm the infection of <jats:italic>Fusobacterium nucleatum<\/jats:italic>. Further appropriate treatments were given, and the patients recovered well. Patient 1 was a 73-year-old male with a 20-day history of left-sided limbs weakness. A brain MRI showed a space-occupying lesion with a heterogeneously ring-enhancement character in the right frontal lobe. This patient underwent puncture biopsy of the lesion with robot-assisted guidance to confirm a brain abscess. Empirical antibiotic therapy was immediately given until the pathogen was identified as <jats:italic>Fusobacterium nucleatum<\/jats:italic>; thus, he received specific antibiotic therapy with metronidazole and recovered well after treatment. Patient 2 was a 22-year-old female with heart disease history who complained of right-sided limb weakness for nine days. A brain MRI showed a circular enhanced lesion with a thin capsule wall and surrounding edema in the left frontal lobe. This patient underwent puncture drainage of the lesion with robot-assisted guidance and a brain abscess was confirmed. Empirical antibiotic therapy was given until the pathogen was identified as <jats:italic>Fusobacterium nucleatum<\/jats:italic> and then she also received metronidazole treatment. Her symptoms recovered and the lesion disappeared after 1\u2009month. Hence, we reviewed the diagnosis and treatment of cryptogenic brain abscess caused by <jats:italic>Fusobacterium nucleatum<\/jats:italic> and highlight that precise neurosurgical interventions and identification of causative pathogens are crucial for the management of brain abscess.<\/jats:p>","DOI":"10.3389\/fnins.2023.1248493","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T10:39:45Z","timestamp":1700735985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Case report: Two case reports of cryptogenic brain abscess caused by Fusobacterium nucleatum and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Zuoxin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linxi","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchun","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengqing","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbo","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guolong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/prd.12426","volume":"2000","author":"Alon-Maimon","year":"2022","journal-title":"Fusobacterium nucleatum and cancer. Periodontol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1080\/14787210.2018.1489722","article-title":"Anti-infective treatment of brain abscess","volume":"16","author":"Bodilsen","year":"2018","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2825","DOI":"10.1093\/cid\/ciz1153","article-title":"Long-term mortality and epilepsy in patients after brain abscess: a Nationwide population-based matched cohort study","volume":"71","author":"Bodilsen","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/s41579-018-0129-6","article-title":"Fusobacterium nucleatum \u2013 symbiont, opportunist and oncobacterium","volume":"17","author":"Brennan","year":"2019","journal-title":"Nat. Rev. Microbiol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1212\/WNL.0000000000000172","article-title":"Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis","volume":"82","author":"Brouwer","year":"","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1056\/NEJMra1301635","article-title":"Brain abscess","volume":"371","author":"Brouwer","year":"","journal-title":"N. Engl. J. Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/QCO.0000000000000334","article-title":"Epidemiology, diagnosis, and treatment of brain abscesses","volume":"30","author":"Brouwer","year":"2017","journal-title":"Curr. Opin. Infect. 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Infect. Microbiol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1016\/j.amjmed.2021.05.027","article-title":"Bacterial brain abscess: an outline for diagnosis and management","volume":"134","author":"Corsini Campioli","year":"2021","journal-title":"Am. J. Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.ijid.2021.12.322","article-title":"Diagnosis, management, and outcomes of brain abscess due to gram-negative versus gram-positive bacteria","volume":"115","author":"Corsini Campioli","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2020.0103","article-title":"What you need to know about brain abscesses","volume":"81","author":"De Andres Crespo","year":"2020","journal-title":"Br. J. Hosp. Med. 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Biomed."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"102261","DOI":"10.1016\/j.anaerobe.2020.102261","article-title":"An immunocompetent patient with culture-negative multiple brain abscesses caused by Fusobacterium nucleatum","volume":"65","author":"Kenig","year":"2020","journal-title":"Anaerobe"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1099\/acmi.0.000499.v4","article-title":"Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report","volume":"5","author":"Lamtri Laarif","year":"2023","journal-title":"Access Microbiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1055\/s-0039-1693159","article-title":"Bacterial infections of the central nervous system","volume":"39","author":"LaPenna","year":"2019","journal-title":"Semin. 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Biochem."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e16003","DOI":"10.1016\/j.heliyon.2023.e16003","article-title":"Clinical and radiological characteristics of brain abscess due to different organisms in hospitalized patients: a 6-year retrospective study from China","volume":"9","author":"Su","year":"2023","journal-title":"Heliyon"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.tim.2022.08.010","article-title":"Fusobacterium nucleatum, a key pathogenic factor and microbial biomarker for colorectal cancer","volume":"31","author":"Wang","year":"2023","journal-title":"Trends Microbiol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.3389\/fnins.2018.01054","article-title":"A clinical report of two cases of cryptogenic brain abscess and a relevant literature review","volume":"12","author":"Zhou","year":"2019","journal-title":"Front. 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