Recurrent breast abscess with isolation of Fusobacterium nucleatum: a case report and review of oncogenic potential

Abstract

Breast abscesses are uncommon in non-lactating adolescents and are typically caused by common skin flora.  Fusobacterium nucleatum, an anaerobic gram-negative bacterium primarily associated with periodontal disease, has recently been implicated in colorectal and breast tumorigenesis but is rarely identified in breast infections. We report the case of a 14-year-old previously healthy female who presented with a right breast abscess requiring incision and drainage (I&D). Initial cultures yielded anaerobic gram-positive organisms; however, following recurrence one month later with a larger abscess, operative cultures isolated Fusobacterium nucleatum. She was successfully treated with targeted intravenous antibiotics followed by a four-week oral course. This case highlights the importance of considering atypical anaerobic pathogens in persistent or recurrent pediatric breast infections. The identification of F. nucleatum in breast tissue raises questions regarding microbial dysbiosis and its potential long-term implications, underscoring the need for appropriate antimicrobial management and close clinical follow-up.