Clinical Features and Outcomes of Fusobacterium Species Infections in a Ten-Year Follow-up

Abstract

ObjectiveAlthough uncommon, Fusobacterium infections have a wide clinical spectrum, ranging from local pharyngeal infections to septic shock. Our aim was to characterize and analyze the clinical features and outcomes in patients with Fusobacterium infections, and determine which variables were able to predict a poor outcome.MethodsWe conducted a retrospective, hospital-based study using the computerized records of a second-level Spanish general hospital, serving a population of 155,000 inhabitants. The cohort was enrolled among patients cared for at the hospital between 2007 and 2016. Demographic, clinical data, microbiological characterization and outcomes at discharge, were analyzed.ResultsWe collected data for all 26 patients over a 10-year period (annual incidence of 1.78 per 100,000), with an incidence of bacteremia of 0.53 cases per 100,000 population per year. F. nucleatum and F. necrophorum were the most frequent isolations (53.8% and 38.5%, respectively). F. necrophorum was found to be associated with a younger population. Although we found no deaths attributable to Fusobacterium, 15 patients (57%) were found to have severe infections due to this pathogen, and 7 patients (26.9%) were admitted to the Intensive Care Unit (ICU). The only identifiable risk factor for a severe infection (sepsis, septic shock or ICU admission) was the presence of bacteremia.ConclusionsFusobacterium infections are uncommon. F. necrophorum tends to cause infection in younger individuals, while F. nucleatum has a preference for older patients. The clinical spectrum is wide, ranging from local, nonsevere infections, such as sinusitis or pharyngitis, to abscess formation and life-threatening infections.

Heat-Killed Fusobacterium nucleatum Triggers Varying Heme-Related Inflammatory and Stress Responses Depending on Primary Human Respiratory Epithelial Cell Type

“…Taken together, this would imply that Fn-driven inflammation plays a role in disease induction. Surprisingly, respiratory diseases have also been considered a risk factor for Fn [ 9 , 10 ] which would suggest that Fn-driven inflammation may also contribute to respiratory disease development.…”

Severe case of pneumonia with pleural effusion in an immunocompromised woman due toFusobacterium necrophorum

“…Although Lemierre’s syndrome is the most widely recognised infection involving fusobacteria, the clinical spectrum can be wide, and clinicians can attend to patients with severe infections without any obvious oropharyngeal involvement, as with the current case 2 5 6. However, it is worth noting that F. necrophorum causes quite a distinct spectrum of respiratory tract infections when compared with F. nucleatum .…”

“…The most common finding is the presence of septic emboli and secondary lung abscesses caused by septic thrombophlebitis of the internal jugular vein. The presence of pneumonia and parapneumonic pleural effusion is rare if Lemierre’s syndrome is not present 5…”

Bacteraemia and multiple liver abscesses due toFusobacterium nucleatumin a patient with oropharyngeal malignancy

“…The most widely known clinical presentation of fusobacteria infections is Lemierre’s syndrome 2. However, infections due to fusobacteria cover a wide clinical spectrum, ranging from mild oropharyngeal infections to sepsis and abscess formation 3–5…”

“…In terms of clinical manifestations by fusobacteria, predisposing factors such as malignancy, immunosuppression, diabetes mellitus and chronic liver disease play an important role 3. A number of case reports have been published emphasising the importance of these conditions 5. Sepsis, bacteraemia and abscess formation are therefore associated with the above-mentioned underlying conditions.…”