Fusobacterium Nucleatum Lung Abscess following Weeks After Smoke Inhalation Injury

Fusobacterium nucleatum is an anaerobic gram-negative organism and an uncommon cause of severe pleuropulmonary infection in immunocompetent hosts. We report a 63-year-old man with chronic obstructive pulmonary disease who developed a lung abscess due to F. nucleatum 4 months after smoke inhalation injury requiring intubation. He presented with months of productive cough, fever, and weight loss. Imaging demonstrated a large pleural-based thoracic mass. Interventional radiology drainage yielded 320 mL of foul-smelling purulent fluid, with anaerobic cultures growing F. nucleatum . The patient was successfully treated with drainage and prolonged antimicrobial therapy. Smoke inhalation injury may cause persistent airway epithelial damage and impaired immune defenses, predisposing to opportunistic anaerobic infections. Clinicians should consider anaerobic pathogens such as F. nucleatum in patients with indolent pleuropulmonary infections following smoke inhalation exposure.