FATAL SEPSIS DUE TO A BETA-LACTAMASE-PRODUCING STRAIN OF FUSOBACTERIUM-NUCLEATUM SUBSPECIES POLYMORPHUM

A patient with Waldenstrom's macroglobulinemia was treated empirically with imipenem for sepsis related to oropharyngeal infection and respo nded within 24 hours. When blood cultures yielded Streptococcus agalac tiae, the regimen was changed to ampicillin and gentamicin. The patien t's condition rapidly deteriorated, and she died 3 days later. After h er death, a strain of Fusobacterium nucleatum subspecies polymorphum p roducing beta-lactamase (PEN-Y; group 2a) was isolated from blood cult ures. A literature review revealed increasingly frequent isolation of beta-lactamase-producing strains off. nucleatum. Thus strains of F. nu cleatum isolated from blood and other specimens from patients with ser ious infections should be tested for beta-lactamase production.