Fusobacterium necrophorum as an Emerging Pathogen of Acute Mastoiditis

Gelbart, Miri; Bilavsky, Efraim; Chodick, Gabriel; Raveh, Eyal; Levy, Itzhak; Ashkenazi‐Hoffnung, Liat

doi:10.1097/inf.0000000000002021

Cited by 24 publications

(24 citation statements)

References 23 publications

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“…Then, culture methods and identification of anaerobic bacteria improved notably since the use of specific molecular diagnostic tests such as PCR . The third hypothesis highlighted by Gelbert et al are the pre‐admission use of antibiotics leading to microorganisms' selection and the emergence of virulent pathogens as F necrophorum …”

Section: Discussionmentioning

confidence: 99%

“…In some cases, it can lead to invasive head and neck infections such as sinusitis, peritonsillar abscesses or mastoiditis . The increase in the incidence of Fusobacterium mastoiditis, particularly in healthy children, has been documented by several authors over the last decade . Clinicians need to be aware of this rise since cerebral complications in acute Fusobacterium mastoiditis, particularly septic thrombosis, are not rare.…”

Section: Introductionmentioning

confidence: 99%

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Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Coudert

Fanchette

Regnier

et al. 2019

Clinical Otolaryngology

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Coudert

Fanchette

Regnier

et al. 2019

Clinical Otolaryngology

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“…Further complications were observed in all children; 83% of them had an epi-or intradural abscess and all of them required mastoidectomy. In the study by Gelbart et al [7] F. necrophorum was detected (in cultures as well as using PCR, mainly using PCR) in 13% of AM cases. Out of all AM cases with further complications, 41% were caused by this pathogen.…”

Section: Discussionmentioning

confidence: 93%

“…This anaerobic species has been recently the object of much interest as a pathogen responsible for severe course of AM [7,25,38]. Out of 43 children with AM caused by this bacterial species, as many as 93% required surgical intervention i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The increased frequency of F. necrophorum infections has not been elucidated to date. Potential causes include restrictions in antibiotic therapy, changes in pathogenic virulence, state-of-the--art pathogen identification methods, common use of pneumococcal vaccines leading to microfloral changes and F. necrophorum carrier status being more common, and the increased penicillin resistance of F. necrophorum strains [7,38].…”

Section: Discussionmentioning

confidence: 99%

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Acute mastoiditis in children population

Zonenberg¹,

Hassmann‐Poznańska

Skotnicka

et al. 2019

Pol Otorhino Rev

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Aim: The aim of the study was to perform a retrospective analysis of the medical documentation of patients treated for acute mastoiditis (AM) at the Department of Pediatric Otolaryngology in Bialystok and to review the available literature on this subject so as to determine optimum AM management principles. Material and methods:A retrospective analysis of 40 patients treated for AM in 2001-2017 was performed. Patient enrollment was based on the AM diagnostic criteria established by Anthonsen et al [15]. results:The mean age of the subjects was 46 months, with 37% of children being less than 2 years old. No previous episodes of acute otitis media (AOM) had been reported in 2/3 of cases. Prior to hospital admission, antibiotics had been administered to 69% of patients. In laboratory investigations, 95% of patients presented with elevated inflammation markers (CRP, leukocytosis), with the values of these markers being higher in patients qualified for surgery. Indications for computed tomography (CT) scans included lack of improvement following 48 hours of conservative treatment or the presence of symptoms of subperiosteal abscesses. CT scans were performed in 35% of patients. Conservative treatment alone was administered to 24 patients (60%); this included myringotomy with/without ventilation tube insertion and intravenous antibiotic therapy. Ceftriaxone was the most commonly used antibiotic, being administered to 75% of patients. Mastoidectomy was required in 16 patients. The most common indication (30%) for mastoidectomy consisted in the presence of subperiosteal abscess. conclusion:In non-complicated cases of AM, there is no need for routine performance of CT scans; myringotomy with or without insertion of ventilation drains should be performed and empirical intravenous antibiotic therapy should be started.In the presence of a subperiosteal abscess, a contrast-enhanced CT scan and mastoidectomy are recommended. Deterioration of patient's condition or lack of improvement after 48 hours of conservative treatment requires a CT scan being performed and the decision on potential mastoidectomy being made on the basis of the scan. Keywords:acute mastoiditis, children, acute otitis media, treatment streszczenie: cel: Celem pracy była analiza retrospektywna dokumentacji chorych leczonych z powodu ostrego zapalenia wyrostka sutkowatego (OZWS) w Klinice Otolaryngologii Dziecięcej w Białymstoku, jak również dostępnego piśmiennictwa na ten temat, w celu określenia optymalnych zasad postępowania w OZWS. Materiał i metody:Analiza retrospektywna 40 pacjentów leczonych z powodu OZWS w latach 2001-2017. Kryteria włączenia pacjentów przyjęto za Anthonsen i wsp.[15]. wyniki: Średni wiek badanych wynosił 46 miesięcy, 37% dzieci miało mniej niż 2 lata. 2/3 przypadków nie było poprzedzonych wcześniejszymi epizodami OMA. 69% chorych otrzymywało antybiotyk przed przyjęciem do szpitala. W badaniach laboratoryjnych u 95% chorych stwierdzono podwyższone wykładniki stanu zapalnego (CRP, leukocytoza), ich wartość była wyższa wśród chorych zak...

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