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Isolation of Fusobacterium nucleatum and electron microscopic observations of spirochetes from tropical skin ulcers in Papua New Guinea.

Tropical ulcer is a disabling condition of the lower leg affecting mainly young adults and older children. Microscopic observations of lesion material have shown fusiform bacilli and spirochetes. We used anaerobic culture techniques to isolate and identify these fusiform bacilli. Electron microscopic (EM) studies were performed to characterize the spirochetes. Material collected on swabs was used to inoculate pre-reduced media and to prepare smears for gram staining; the swabs were placed in fixative for EM study. After incubation, colonies containing fusiform bacilli were subcultured. The anaerobic gram-negative fusiform isolates were identified as Fusobacterium nucleatum using biochemical reactions, hemagglutination testing, and reaction of antigen preparations of the isolates and ATCC strains in serological tests with rabbit antisera. EM observations of negatively stained spirochetes revealed an 8-16-8 periplasmic flagellar arrangement. F. nucleatum and spirochetes may participate in the pathogenesis of this polymicrobic infection.

Adolescent↗

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

A study of the predominant microflora in active sites of noma (cancrum oris) lesions was carried out in eight noma patients 3-15 years of age in Sokoto State in northwestern Nigeria. Paper point sampling and conventional anaerobic microbiologic techniques were used. Fusobacterium necrophorum was recovered from 87.5% of the noma lesions. Oral microorganisms included Prevotella intermedia, alpha-hemolytic streptococci, and Actinomyces spp. which were isolated from 75.0%, 50.0%, and 37.5% of the patients, respectively. Peptostreptococcus micros, Veillonella parvula, Staphylococcus aureus, and Pseudomonas spp. were each recovered from one lesion. The F. necrophorum and P. intermedia isolates were tested for antibiotic sensitivity to clindamycin, tetracycline, metronidazole, and penicillin using the E-test, and all strains were observed to be sensitive to all of the antibiotics tested with the exception of one strain of P. intermedia, which showed resistance to penicillin. The first reported isolation from human noma lesions of F. necrophorum, a pathogen primarily associated with animal diseases, may have important etiologic and animal transmission implications.

Adolescent↗

Fusobacterium necrophorum and Actinomyces pyogenes associated facial and mandibular abscesses in blue duiker.

Anaerobic and aerobic cultures of facial and mandibular abscesses were made from 12 blue duiker (Cephalophus monticola fusicolor) housed at the Deer and Duiker Research Facility of the Pennsylvania State University (USA). Increases in concentrations of total protein and serum globulin occurred in all cases. Actinomyces pyogenes was isolated from nine animals. Fusobacterium necrophorum was present in eight and Bacteroides sp. was found in seven animals; other genera of isolated bacteria included: Streptococcus (from two animals), Lactobacillus (one), Staphylococcus (one) and Actinomyces (two). Eight (67%) of affected animals were less than or equal to 2 yr of age. Facial soft tissues and mandibles were the tissues most often affected. Tissues within the oral cavity were not affected at the time of presentation. A common finding, not reported in other host species with necrobacillosis, was the presence of nondestructive mandibular proliferation.

Abscess↗

Effects of tylosin on concentrations of Fusobacterium necrophorum and fermentation products in the rumen of cattle fed a high-concentrate diet.

OBJECTIVE: To determine effects of tylosin on ruminal concentrations of Fusobacterium necrophorum and fermentation products in cattle during rapid adaptation to a high-concentrate diet. ANIMALS: 6 steers fitted with ruminal cannulas. PROCEDURE: Steers were assigned randomly to 2 treatment groups and switched from a 0 to an 85% concentrate diet during a 4-day period. Cattle received this diet, with or without tylosin (90 mg/steer/d), for 4 weeks. Samples of ruminal contents were collected daily beginning 2 days before the treatment protocol and in the first week of concentrate feeding. Four subsequent samples were collected at weekly intervals. Concentration of F. necrophorum in samples was determined, using the most-probable-number technique. Ruminal pH and concentrations of volatile fatty acids (VFA), lactate, and ammonia also were determined. All steers received both treatments separated by 4 weeks (cross-over design), during which time they were fed alfalfa hay only. RESULTS: In control steers, concentration of F. necrophorum increased in response to the high-concentrate diet. Tylosin-fed steers had lower concentrations of F. necrophorum than control steers at all times during concentrate feeding. However, ruminal pH and concentrations of lactate, VFA, and ammonia did not differ between treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Tylosin caused a significant reduction in ruminal concentrations of F. necrophorum during rapid adaptation to a high-concentrate diet but had no effect on fermentation products. The reduction in ruminal concentration of F. necrophorum helps explain the reduction in prevalence of hepatic abscesses reported in tylosin-fed feedlot cattle.

Ammonia↗

Haemophilus parainfluenzae and Fusobacterium necrophorum liver abscess: a case report.

Liver abscess is a potentially life-threatening disease. The clinical features of pyogenic liver abscess are variable and probably correlate with a variety of pathogenic microorganisms and underlying diseases that may be involved. The most common pathogen of liver abscess in Taiwan is Klebsiella pneumoniae. Diabetes mellitus and hepatobiliary calculus are major diseases associated with liver abscess. Haemophilus parainfluenzae is a commensal of the upper respiratory tract, but is an uncommon isolate in liver abscess. We describe a 44-year-old man with liver abscess caused by mixed H. parainfluenzae and Fusobacterium necrophorum infection. He received percutaneous liver abscess drainage and intravenous antibiotic therapy for 3 weeks and fully recovered. No recurrence occurred during the follow-up period of 4 months.

Adult↗

Ultrastructure and molecular characterization of Fusobacterium necrophorum biovars.

The ultrastructural features and molecular components of 18 strains of Fusobacterium necrophorum biovars A, AB and B, isolated from animal and human infections, were examined by electron microscopy, multilocus enzyme electrophoresis (MEE) and by sodium dodecyl sulfate-gradient polyacrylamide gel electrophoresis (SDS-PAGE). High resolution scanning electron microscopy revealed that the strains possessed a convoluted surface pattern. Transmission electron microscopy showed that all strains possessed a cell wall structure typical of gram-negative bacteria. Bleb formation was not uncommon. Numerous extracellular materials, resembling lipopolysaccharide (LPS) fragments, surrounded cells of both human strains and biovar B animal strains. Biovar A field strains revealed capsules as stained by ruthenium red whereas a stock culture strain showed the capsule only when immunostabilized with hyperimmune serum. Starch gel electrophoresis showed all strains to possess adenyl kinase, glutamate dehydrogenases and lactate dehydrogenase; each enzyme migrated uniformly (monomorphic) among the strains and represented an electrotype. However, SDS-PAGE indicated differences in the protein profiles between all of the strains; the most distinctly different was a human isolate (FN 606). Silver staining to detect LPS showed extensive "ladder" patterns among the majority of biovar A strains but not in the animal biovar B strains. Immunoblotting of LPS with a rabbit antiserum prepared against phenol extracted LPS from a biovar A animal isolate (LA 19) suggested marked variability in the LPS antigens among the isolates studied.

Animals↗

Cavernous sinus thrombosis and cerebral infarction caused by Fusobacterium nucleatum infection.

We report an unusual case of fusobacterial infection with secondary intracranial invasion. The condition was complicated by a cavernous sinus thrombosis and ischemic stroke. The patient was a 63-year-old woman with no history of systemic disease who had undergone a tooth extraction before the onset of symptoms. She initially suffered from sphenomaxillary sinusitis and a cavernous sinus thrombosis, and subsequently developed meningitis. Cerebrospinal fluid examination suggested a pyogenic infection. Anaerobic culture revealed Fusobacterium nucleatum. However, despite immediate antibiotic therapy, her condition remained unstable over the next few days, and she eventually developed an ischemic stroke. We describe our experience in the management of this case of anaerobic meningitis and the unusual complication of ischemic stroke; this case suggests that more aggressive therapy in addition to empirical antibiotics may be warranted.

Cavernous Sinus Thrombosis↗

Efficacy of vaccination against Fusobacterium necrophorum infection for control of liver abscesses and footrot in feedlot cattle in western Canada.

A randomized and blinded field trial was carried out to evaluate the efficacy of a Fusobacterium necrophorum bacterin for control of liver abscesses and footrot under commercial feedlot conditions in western Canada. Half of the vaccinated and half of the unvaccinated control animals had ad libitum access to a forage-based (ALF) growing diet. The other half of each group was limit-fed a grain-based (LFG) growing diet. The overall prevalence of A and A+ liver abscesses in this trial was 16.7%. A strong association was found between diet group and presence of A or A+ liver abscessation at slaughter. Diet group modified the effect of vaccination on the prevalence of liver abscesses at slaughter, and on the incidence of footrot during the feeding period. The odds that a vaccinated animal in the ALF group would have an A or A+ liver abscess at slaughter were less than 1/3 the odds that an unvaccinated animal in the same diet group would have an A or A+ liver abscess at slaughter (OR = 0.27, [95% CI: 0.07 to 1.02], P = 0.05). The overall incidence of footrot in this trial was 6.5%. The odds that a vaccinated animal in the ALF group would be treated for footrot were less than 1/5 the odds that an unvaccinated animal in the same group would be treated for foot-rot (OR = 0.18, [95% CI: 0.04 to 0.82], P = 0.03). Within the LFG group there were no differences between vaccinated and unvaccinated animals in the odds of an animal being treated for footrot, or in the odds of having an A or A+ liver abscess score at slaughter. This trial suggests that vaccination against F. necrophorum infection may have applications to decrease the prevalence of severe liver abscesses at slaughter and decrease footrot treatments in certain diet situations.

Animals↗

[Sepsis caused by Fusobacterium necrophorum (Lemierre syndrome): a rare complication of acute pharyngotonsilitis].

Lemierre syndrome is defined as an acute pharyngotonsillar infection that has spread into the lateral pharyngeal space causing thrombophlebitis of the internal jugular vein with consecutive metastatic emboli. The syndrome is most often caused by Fusobacterium (F.) necrophorum and usually involves young, previously healthy people. We present a healthy 20-year-old man who suddenly developed with high fever and sore throat followed by dyspnea, tachypnea and cough on the third day of illness. His condition worsened despite outpatient intramuscular penicillin therapy (1600 000 IU/day). He was admitted to Dr. Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, on the sixth day of his illness with clinical signs of sepsis. Chest radiograph showed bilateral multiple infiltrates. F. necrophorum was isolated from blood culture. Swelling of the neck was also observed on the fourteenth day of illness, however, thrombophlebitis of the jugular vein was not diagnosed on ultrasound examination. The patient was treated with clindamycin for five weeks and recovered completely.

Acute Disease↗

Osteomyelitis of the pelvis due to Fusobacterium nucleatum.

Anaerobic pelvic osteomyelitis occurs rarely in children. A case of Fusobacterium nucleatum osteomyelitis of the right ilium [correction of ileum] in a child without apparent risk factors is described. This case emphasizes the value of diagnostic aspirates. Therapy with a combination of intravenous and oral clindamycin led to successful resolution of the infection.

Child↗

[Right-sided endocarditis due to Fusobacterium nucleatum].

We present 1 case of right sided endocarditis caused by Fusobacterium nucleatum in a patient with intravenous drug addiction and human immunodeficiency. The clinical features were fever, anemia, and pulmonary embolism. The echocardiogram showed a giant vegetation originated from the right atrial wall prolapsing in diastole into the right ventricle which disappeared after the patient presented pulmonary embolism. The clinical course was uncontrolled with empiric antimicrobial therapy but it was good with metronidazol. The cases previously described in the literature caused by gram-negative anaerobic bacteria are discussed and compared with the present case.

Adolescent↗

Septic arthritis and osteomyelitis in a bovine digit: a mixed infection of Actinomyces pyogenes and Fusobacterium necrophorum.

A 4-year-old beefmaster cow was examined for a left hind leg lateral claw lameness due to septic arthritis of the distal interphalangeal joint and associated osteomyelitis of the second and third phalanges. Actinomyces pyogenes and Fusobacterium necrophorum, which have been demonstrated previously to act synergistically in ovine heel abscesses, were isolated from the affected digit. A claw amputation was performed because of the advanced destructive nature of the lesion.

Actinomyces↗

Failure to induce in rabbits effective immunity to a mixed infection of Fusobacterium necrophorum and Corynebacterium pyogenes with a combined bacterin.

Failure to induce in rabbits effective immunity to a mixed infection of Fusobacterium necrophorum and Corynebacterium pyogenes with a combined bacterin. Onderstepoort Journal of Veterinary Research, 44 (4), 253--2;6 (1977). Rabbits were immunized with alum-precipitated, oil adjuvant and an untreated bacterin composed of F. necrophorum and C. pyogenes. Immunized rabbits were challenged intradermally with a mixture of F. necrophorum and C. pyrogenes. Immunized rabbits were challenged intradermally with a mixture of F. necorphorum and C. pyrogenes. Initially a low level of initial transient resistance could be demonstrated but a solid immunity could not be established.

Animals↗

Biochemical characterization of the leukotoxins of three bovine strains of Fusobacterium necrophorum.

The biochemical characteristics of the leukotoxins of 3 bovine isolates of Fusobacterium necrophorum which represent biotypes A, AB, and B were compared. Two methods were used for the production of the leukotoxins: medium M-1 continuous dialysis sac cultures and brain-heart infusion agar plate cultures. The supernatant cultural fluids were fractionated sequentially by membrane-partition chromatography, using ultrafilters with approximate molecular weight (mol wt) exclusion limits of 100,000, 10,000, 2,000, and 500. The ultrafiltrates (less than 500 mol wt) were fractionated by gel-permeation chromatography, using G-10 Sephadex. The leukotoxins of the 3 F necrophorum strains were estimated to have a molecular weight between 350 and 450. The leukotoxins in the ultrafiltrates (less than 500 mol wt) were stable at 60 C for 4 hours and at 100 C for 30 minutes, stable to extremes of pH (3 to 11), and stable to degradative enzymes including trypsin, protease, alpha-amylase, lipase, deoxyribonuclease, and ribonuclease. Significant differences were not observed in the biochemical characteristics of the leukotoxins produced in vitro by the 3 F necrophorum biotypes. These assays were done, using monolayers of mouse peritoneal macrophages. The monolayers were exposed to the 4 ultrafiltrates of both the continuous dialysis sac and brain-heart infusion agar cultures (pH 7.2) for 4 hours at 4 C, 25 C, and 37 C. Maximal cytotoxic activity in the assays was at 37 C.

Animals↗

Immunization of mice against Fusobacterium necrophorum infection by perenteral or oral administration of vaccine.

Immunization of mice against Fusobacterium necrophorum infection was attempted by using 3 vaccination procedures: (1) intraperitoneal (IP) injection of F necrophorum cells in saline solution, (2) IP injection of cells with added aluminum hydroxide adjuvant, and (3) feeding of a powdered mouse diet containing lyophilized cells. One or 2 weekly IP injections of the bacteria cells (in saline solution) for 3, 6, or 12 weeks resulted in protection of 48.7% to 64.5% of the mice against challenge exposure. Of the 2 control groups (given saline solution only), 100% and 97.4% became infected. Weekly IP injections of bacterial cells in an aluminum hydroxide adjuvant for 3, 6, or 12 weeks resulted in protectivity of 54.1% to 77.5%. Of the control mice (given adjuvant only), 97.5% became infected. Bacterial cells fed to mice at a dose level of 1.5 mg (dry weight)/g of powdered diet for 30 days (4 or 5g of diet each day) resulted in only a delay in the mean time of death as compared with the rapid death of the control mice. The feeding dose of 0.15 mg of cells/g of diet did not delay the mean time of death.

Adjuvants, Immunologic↗

Fusobacterium necrophorum isolated from a hepatic abscess and from mastitic udder secretions in a heifer.

Strains of Fusobacterium necrophorum were isolated from secretions of an udder affected with mastitis (4 strains), an adjacent unaffected udder (3 strains), a superficial inguinal lymph node (2 strains) and a liver abscess (4 strains). These 13 strains were examined bacteriologically together with three known strains: F. necrophorum VPI-2891 and VPI-6161, and Sphaerophorus necrophorus (F. necrophorum) N-167. All strains produced butyric acid from glucose and propionic acid from lactic acid, were positive for the indole reaction, failed to hydrolyse esculin, caused beta-haemolysis and showed sensitivity to penicillin (500 U/ml). They were divided roughly into two groups on the basis of differences in their properties as described below. Six strains belonged to one group and ten strains to the other: the former agglutinated chick red blood cells, formed colonies of type A of Fiévez, were long rods, showed turbid growth in liquid medium and were highly pathogenic for mice; the latter strains, consisting of short bacilli and forming colonies of type B, had no or weak haemagglutinin, showed, in liquid medium, sedimentary growth with a clear supernatant and were not fatal to mice. The 4 strains isolated from the hepatic abscess as well as the F. necrophorum strain VPI-2891 and the Sphaerophorus necrophorus strain N-167 were classified into biovar A. The 9 strains isolated from udder and lymph node, as well as the F. necrophorum strain VPI-6161, were classified into biovar B.

Animals↗

[Lung abscess due to Fusobacterium nucleatum (author's transl)].

A patient with epilepsy, 45 years of age, developed a lung abscess due to Fusobacterium nucleatum which was successfully treated with intravenous lincomycin. Quantitative anaerobic cultures of washed sputum proved to be useful in detecting the causative organism.

Epilepsy↗

Suppression of human peripheral blood lymphocytes by Fusobacterium nucleatum.

Fusobacterium nucleatum has been implicated in the pathogenesis of several diseases, including urinary tract infections, bacteremia, pericarditis, otitis media, and disorders of the oral cavity such as pulpal infections, alveolar bone abscesses, and periodontal disease. In this study, we examined sonic extracts of F. nucleatum strain FDC 364 for its ability to alter human lymphocyte function. We found that the soluble cytoplasmic fraction (CF) of the sonic extract was able to cause a dose-dependent inhibition of human lymphocyte responsiveness to Con A, PHA, PWM, and the recall antigen SKSD. Suppression involved altered DNA, RNA, and protein synthesis; there was no effect on cell viability. The suppressive activity is nondialyzable and heat labile. To achieve maximal suppression in 96-hr cell cultures, the CF had to be added to cells during the first 24 hr of incubation. Inhibition was reduced when the CF was added at 48 hr, and no suppression was observed when addition was at 72 or 96 hr (along with [3H]TdR). Furthermore, cells could be protected from the suppressive effects of the CF by washing within 24 hr of exposure. Suppression did not involve nonspecific effects on thymidine utilization. Although the mechanism of action of the F. nucleatum immunosuppressive activity has not yet been determined, we can rule out a requirement for monocytes/macrophages and activation of T suppressor cells. It has been proposed that impaired host defense may play a pivotal role in the pathogenesis of many diseases. The data presented in this paper suggest that local and/or systemic immunosuppression could be initiated by F. nucleatum. This immunosuppression may alter the nature and consequences of host-parasite interactions, thereby enhancing the pathogenicity of F. nucleatum itself or that of some other opportunistic organism.

Bacterial Proteins↗