Objective
To evaluate in children the clinical severity and evolution of otogenic lateral sinus thrombosis (OLST) due to Fusobacterium necrophorum compared with other bacterial otogenic thrombosis and propose a specific management flowchart for Fusobacterium OLST.
Design
A retrospective multicentre cohort study.
Settings
Four French ENT paediatric departments.
Participants
A total of 260 under 18 years old admitted for acute mastoiditis were included. Initial imaging was reviewed to focus on complicated mastoiditis and 52 OLST were identified. Children were then divided into two groups according to bacteriological results: 28 in the “OLST Fusobacterium group” and 24 in the “OLST other bacteria group”.
Results
There was a significant association between F necrophorum and OLST (P < .001). When compared to the OLST other bacteria group, children in the OLST Fusobacterium group were significantly younger (61 months vs 23 months, P < .01) and had a more severe clinical presentation: higher CRP (113 mg/L vs 175.7 mg/L, P = .02) and larger subperiosteal abscess (14 mm vs 21 mm, P < .01). Medical management was also more intensive in the OLST Fusobacterium group than in the OLST other bacteria group: increased number of conservative surgeries (66.7% vs 92.9%, P = .03) and longer hospital stay (13.7 days vs 19.8 days, P = .02). At the end of follow‐up, the clinical course was good in both groups without any neurological sequelae.
Conclusions
Thrombotic complications are very frequent in case of Fusobacterium mastoiditis and clinicians should be aware of the initial severity of the clinical presentation. Under appropriate management, the clinical course of Fusobacterium OLST is as good as that of other bacterial otogenic thrombosis.
�moeLes auteurs décrivent deux cas de diarrhée à Campylobacter jejuni dans l'espèce équine en France, ayant atteint des poulains ou des adultes. L'affection a été sévère puisque 2 chevaux sont morts sur 6 animaux atteints, un en début d'affection, l'autre quelques semaines après en faisant une récidive. D'autres cas ont été diagnostiqués. Cette gastro-entérite aiguë s'accompagne de symp tômes d'allure grippale. Son diagnostic est relativement facile si , }es excréments diarrhéiques sont traités très rapidement au labo ratoire : examen direct, après ou non coloration, au microscope ; mise en culture sur milieu sélectif, dans les 24 h en général après leur émission.
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