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Fusobacterium necrophorum septicemia following Epstein-Barr virus infectious mononucleosis.

We report herein a case of a 20-year-old previously healthy man who presented, 25 days after the onset of clinically and serologically confirmed Epstein-Barr virus (EBV) infectious mononucleosis, Fusobacterium necrophorum septicemia. The diagnosis of postanginal septicemia was confirmed by repeated demonstration of fusiform, obligate anaerobic, Gram-negative bacilli in anaerobic blood cultures, identified as F. necrophorum 15 days after admission. This case report aims at underlining the need of taking into consideration the possibility of severe Fusobacterium septicemia in previously healthy patients following EBV infectious mononucleosis in order to prevent increased mortality and morbidity.

Journal Article↗

Vertebral osteomyelitis due to Fusobacterium species: report of three cases and review of the literature.

We describe three cases of Fusobacterium spp. diskitis and review with attention to risk factors, clinical features, diagnosis, treatment and outcome. In most of the reported cases, a ear-nose-throat infection was found. Clinical manifestations were similar to those of classic bacterial vertebral osteomyelitis. Clindamycin is the most appropriate antibiotic. The outcome seems to be very good without relapse with appropriate treatment compared to pyogenic vertebral osteomyelitis.

Aged↗

Metastatic complications of Fusobacterium necrophorum sepsis. Two cases of Lemierre's postanginal septicemia.

We have recently encountered two instances of septicemia due to Fusobacterium necrophorum in adolescents. The presence of severe exudative pharyngitis in both patients pointed to the upper respiratory tract as the probable portal of entry. In one case, metastatic infection was manifested by multiple septic pulmonary emboli with associated pleural effusions. In the other case, diffuse encephalopathy and septic arthritis of the left shoulder and hip occurred. Unilateral neck pain, persistent bacteremia, and prolonged fever despite appropriate antibiotics were consistent with the presence of septic jugular thrombophlebitis in both patients. "Postanginal septicemia" caused by F necrophorum, described by Lemierre in the preantibiotic era, was undoubtedly the syndrome manifested by these patients. This condition, formerly uniformly fatal, can readily be diagnosed when anaerobic techniques are used for blood culture, but requires prolonged antibiotic therapy for cure.

Adolescent↗

Infective endocarditis due to Fusobacterium nucleatum: case report and review of the literature.

Endocarditis caused by Fusobacterium nucleatum is exceedingly rare. We report a case of F. nucleatum right-sided endocarditis in a patient with no known intravenous drug abuse. A detailed computer and manual search of the literature using Med-Line and Index Medicus, respectively, revealed a total of five cases of endocarditis due to this species. The clinical characteristics and the patient's hospital course are summarized and reviewed.

Dental Caries↗

Cytotoxic effects of a leukocidin from Fusobacterium necrophorum on bovine hepatic cells.

Cytotoxic effects of a leukocidin from Fusobacterium necrophorum were demonstrated on bovine hepatic cells. The cytotoxic response was dose-dependent and could be inhibited by homologous antiserum. Scanning electron microscopy revealed damaged hepatic cell surface. These findings indicated a pathogenic role of the leukocidin in F. necrophorum infections.

Animals↗

Effects of Fusobacterium necrophorum on the mesenteric microcirculation of guinea pigs.

Thrombi formation was demonstrated in mesenteric microcirculation of guinea pigs inoculated with Fusobacterium necrophorum and the bacterial hemagglutinin (HA). The thrombi were initially observed in venules and later, in arterioles. Immunofluorescence study revealed that the HA bound to the thrombi in the microcirculation. These results indicate that thrombosis is an early step in the pathogenesis of necrosis.

Animals↗

The serum neutralizing antibody response in cattle to Fusobacterium necrophorum leukotoxoid and possible protection against experimentally induced hepatic abscesses.

The serum antileukotoxin antibody response and protection against subsequent experimental challenge with Fusobacterium necrophorum were investigated in 30 steers vaccinated with crude F. necrophorum leukotoxoid. Culture supernatant of F. necrophorum, strain 25, containing leukotoxoid was concentrated. The steers were assigned randomly to six groups (n = 5): PBS control with Stimulon adjuvant; vaccinated with concentrated supernatant diluted to provide 2.5, 5.0, 10.0, or 20.0 ml with the water-soluble Stimulon adjuvant; and 5.0 ml with the Ribi oil-emulsion adjuvant. The steers were injected subcutaneously on days 0 and 21. Blood samples were collected at weekly intervals to monitor serum antileukotoxin antibody titres. On day 42, all the steers were challenged intraportally with F. necrophorum culture. Three weeks later (day 63), the steers were killed and necropsied for examination of their livers and assessment of protection. Steers vaccinated with crude leukotoxoid tended to have higher antileukotoxin titres than the controls, but the difference was not significant. Also, the antibody titre did not appear to be dose-dependent. In the control group, 3 out of 5 steers developed liver abscesses. The incidence of liver abscesses in steers vaccinated with Stimulon adjuvant was not dose related; however, only 8 of the 25 vaccinated steers developed abscesses. None of the steers vaccinated with the 5.0 ml dose with Ribi had any abscesses. Evidence for a relationship between antileukotoxin antibody and protection was shown by the lower titre in those steers that developed abscesses compared to those that did not. It was concluded that antileukotoxin antibody titres probably provided some degree of protection against experimentally induced liver abscesses, but further dose-titration studies using Ribi or possibly another more effective adjuvant will be needed to confirm this.

Adjuvants, Immunologic↗

Endocarditis with acute mitral regurgitation caused by Fusobacterium necrophorum.

Infective endocarditis is uncommon in young children, especially in the absence of structural heart disease. We report the case of a 2-year-old boy who presented with acute rupture of the mitral valve chordae 6 weeks after an episode of Fusobacterium necrophorum septicemia. His heart had been structurally normal before. Mitral valve replacement was successfully performed. This is the first recorded case of endocarditis in a child caused by necrobacillosis.

Bacteremia↗

Multiple brain abscesses and bacteremia in a child due to Fusobacterium necrophorum.

A case of Fusobacterium necrophorum bacteremia and multiple brain abscesses in a 6-year-old child following a Mycoplasma pneumoniae infection is described. Brain abscess due to this microorganism has only been described in three other cases since 1977. The clinical picture was consistent with postanginal septicemia, with septic metastatic complications normally only seen in teenagers and young adults. The patient was successfully treated with a 2-month course of parenteral penicillin G and metronidazole.

Bacteremia↗

Meningitis due to Fusobacterium necrophorum subspecies necrophorum. Case report and review of the literature.

This paper reports a case of fatal meningitis caused by Fusobacterium necrophorum subsp. necrophorum in a previously healthy five-year-old child. The organism was isolated in pure culture from the cerebrospinal fluid and from intracranial pus obtained at autopsy. The role of F. necrophorum in the development of meningitis is reaffirmed and its isolation and identification are discussed. The clinical presentation of the present case resembles the previously published reports and highlights the poor prognosis in spite of appropriate antibiotic treatment.

Child, Preschool↗

Necrotizing pneumonia after pharyngitis due to Fusobacterium necrophorum.

A case of necrotizing pneumonia secondary to Fusobacterium necrophorum is reported. This anaerobic infection commonly originates in the upper respiratory tract and is often accompanied by multiple system disease due to hematogenous seeding. When the lungs are involved, diffuse necrotizing pneumonia with pleural effusions and cavitation results. The course is prolonged, and the diagnosis is frequently delayed. With appropriate antibiotics, the prognosis is good.

Adolescent↗

Anaerobic septicaemia by Fusobacterium necrophorum: Lemierre's syndrome.

Lemierre's syndrome is characterized by acute pharyngotonsillitis with secondary thrombophlebitis of the internal jugular vein which is complicated by multiple metastatic foci of infections. This syndrome is caused by Fusobacterium necrophorum in healthy young persons and is extremely rare in occurrence. A pre-school child with Lemierre's syndrome is reported. The diagnostic and therapeutic aspects are emphasized in order to sensitize physicians to this uncommon condition.

Child, Preschool↗

Septic arthritis of the hip by Fusobacterium necrophorum after tonsillectomy: a form of Lemierre syndrome?

UNLABELLED: Lemierre syndrome used to be a complication of severe oropharyngeal infection with regional thrombophlebitis, septicaemia and septic metastatic infections caused by Fusobacterium necrophorum in the pre-antibiotic era. A case of septic arthritis of the hip caused by F. necrophorum as a complication of tonsillectomy is reported in a 9-year-old boy. CONCLUSION: Lemierre syndrome, usually seen after an oropharyngeal infection, can also complicate tonsillectomy.

Arthritis, Infectious↗

Septic arthritis of the hip due to Fusobacterium nucleatum.

Anaerobic bacteria are uncommon pathogens in septic arthritis. We report a case of pyarthrosis of the right hip caused by Fusobacterium nucleatum, following a transient synovitis in an otherwise healthy boy. There are only a few cases involving this species described in the literature. This report illustrates the difficulty of isolating this unusual organism and emphasises the usefulness of the Bactec blood culture bottles for the recovery of anaerobic bacteria.

Arthritis, Infectious↗

Molecular diagnosis of Fusobacterium necrophorum infection (Lemierre's syndrome).

Presented here is the case of a 27-year-old male with atypical features of Lemierre's syndrome in which a definitive diagnosis was achieved using molecular methods. While routine investigations, including bacterial cultures, were unhelpful, two real-time PCR assays demonstrated Fusobacterium necrophorum-specific DNA in aspirates from brain and renal abscesses. This is the first report demonstrating that a laboratory diagnosis can be made using molecular methods in suspected cases of Lemierre's syndrome. Use of these methods can thus resolve diagnostic confusion, prevent unnecessary investigation, and direct specific antimicrobial treatment.

Adult↗

Fusobacterium in presumed Actinomyces canaliculitis.

Based on stained smears of material obtained from the canaliculus, three cases of canaliculitis were presumed to be caused by Actinomyces. Cultures of these cases showed Fusobacterium to be the probable infectious agent producing the disease.

Actinomyces↗

The effects of Escherichia coli endotoxin as a trigger for hepatic infection of rabbits with Fusobacterium necrophorum.

To evaluate the effects of endotoxin in hepatic infection with Fusobacterium necrophorum, rabbits were given several combinations of F. necrophorum and Escherichia coli endotoxin. Severe hepatic necrosis with multiplication of F. necrophorum was induced by inoculation of endotoxin via the bile duct and following inoculation of both endotoxin and F. necrophorum. Inoculation with F. necrophorum alone, preceded by inoculation of endotoxin via the bile duct, also induced hepatic necrosis, whereas rabbits which received a single inoculation of endotoxin or F. necrophorum had only slight necrotic lesions. The pathogenetic mechanism of experimental hepatic infection with F. necrophorum is discussed.

Animals↗