Fusobacterium necrophorum septicemia complicated by liver abscess

Hagelskjaer, L H; Pedersen, Gert Frølund

doi:10.1111/j.1699-0463.1993.tb00199.x

Cited by 27 publications

(20 citation statements)

References 9 publications

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“…36 Initial work trying to determine if human strains will fit into current animal biovar designations suggests that strains isolated from humans may not follow the animal biovar designation. 37 Although not frequently isolated, infections in humans involving F. necrophorum include necrotic tonsillitis with post-anginal septicemia (Lemierre's syndrome), [38][39][40][41] oral and dental infections, brain abscesses, empyema, hepatic and intra-abdominal abscesses, and endocarditis, [42][43][44] and mastoiditis, meningitis, and venous sinus thrombosis. 45 Whether P. intermedia was the black-pigmented member of the organisms considered as Bacteroides melaninogenicus in earlier work associated with noma lesions is not clear.…”

Section: Discussionmentioning

confidence: 99%

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

Falkler¹,

Enwonwu²,

Idigbe³

1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. 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.Noma (cancrum oris) is a destructive gangrenous stomatitis occurring mainly in children. It may lead to devastating facial deformity, circumferential scarring, stenosis of the mouth, and in many cases death. This disease occurs almost exclusively among poor malnourished children in developing countries.

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Section: Discussionmentioning

confidence: 99%

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

Falkler¹,

Enwonwu²,

Idigbe³

1999

The American Journal of Tropical Medicine and Hygiene

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“…Liver abscesses, commonly multiple (37,92,125,218,227,279,286,365,400), were identified in 4% of patients in the current series of Lemierre's syndrome and splenic abscesses (9,106,219,222,236,327,392) in 3% patients. Liver abscesses have been reported in other necrobacillosis cases not fulfilling the criteria for Lemierre's syndrome (8,176,188,199,296,379). Although abdominal pain is a common presenting symptom (8 out of 15 patients in the series described by Hagelskjaer et al [177]), peritonitis is a rare complication.…”

Section: Natural History and Forms Of F Necrophorum Septicemiamentioning

confidence: 98%

“…Patients ranged from 3 to 57 years, with a median of 17 years. Two patients had a history of upper respiratory tract infection months before (176,188). Among the patients with bone or joint infection, four gave a history of preceding trauma or overuse of the affected area.…”

Section: Natural History and Forms Of F Necrophorum Septicemiamentioning

confidence: 99%

“…Many reports describe how infection settled only after drainage of pus, whether it was a collection in the neck such as a peritonsillar or lateral pharyngeal abscess (97), an empyema, (169), a liver abscess (176,227), septic arthritis (32,156), or an abscess in a muscle (398). It is therefore a key part of management to assess the patient for evidence of a collection that needs to be drained.…”

Section: Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Human Infection withFusobacterium necrophorum(Necrobacillosis), with a Focus on Lemierre's Syndrome

2007

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SUMMARYSummary:Human infection withFusobacterium necrophorumusually involvesF. necrophorumsubsp.funduliformerather thanF. necrophorumsubsp.necrophorum, which is a common pathogen in animals. Lemierre's syndrome, or postanginal sepsis, is the most common life-threatening manifestation. Tonsillitis is followed by septic thrombophlebitis of the internal jugular vein and then a septicemia with septic emboli in lungs and other sites. Recent evidence suggests thatF. necrophorumcan be limited to the throat and cause persistent or recurrent tonsillitis.F. necrophorumis unique among non-spore-forming anaerobes, first for its virulence and association with Lemierre's syndrome as a monomicrobial infection and second because it seems probable that it is an exogenously acquired infection. The source of infection is unclear; suggestions include acquisition from animals or human-to-human transmission. Approximately 10% of published cases are associated with infectious mononucleosis, which may facilitate invasion. Recent work suggests that underlying thrombophilia may predispose to internal jugular vein thrombophlebitis. Lemierre's syndrome was relatively common in the preantibiotic era but seemed to virtually disappear with widespread use of antibiotics for upper respiratory tract infection. In the last 15 years there has been a rise in incidence, possibly related to restriction in antibiotic use for sore throat.

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“…Indeed, F. necrophorum has now been isolated from human noma lesions . Although being predominantly an animal pathogen, F necrophorum has been isolated from infections in man such as necrotic tonsillitis with post-anginal septicemia (Lemierre's syndrome) (Lemierre, 1936;Seidenfeld et al, 1982;Karanas et al, 1995), oral and dental infections, brain abscesses, empyema, hepatic and intra-abdominal abscesses and endocarditis (Finegold, 1977;Hagelskjaer and Pedersen, 1993;Meis et al, 1993), and mastoiditis, meningitis, and venous sinus thrombosis (Beder-Meunier et al, 1994). F. necrophorum has been isolated from the gastrointestinal tract, blood, body fluids (Balows et al, 1975), and genitourinary tract of humans and animals (Smith, 1975).…”

Section: Microbiological Reviewmentioning

confidence: 99%

Oro-Facial Gangrene (Noma/Cancrum Oris): Pathogenetic Mechanisms

Enwonwu

Falkler

Idigbe

2000

Critical Reviews in Oral Biology & Medicine

128

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Cancrum oris (Noma) is a devastating infectious disease which destroys the soft and hard tissues of the oral and para-oral structures. The dehumanizing oro-facial gangrenous lesion affects predominantly children ages 2 to 16 years, particularly in sub-Saharan Africa, where the estimated frequency in some communities varies from I to 7 cases per 1000 population. The risk factors are poverty, malnutrition, poor oral hygiene, residential proximity to livestock in unsanitary environments, and infectious diseases, particularly measles and those due to the herpesviridae. Infections and malnutrition impair the immune system, and this is the common denominator for the occurrence of noma. Acute necrotizing gingivitis (ANG) and oral herpetic ulcers are considered the antecedent lesions, and ongoing studies suggest that the rapid progression of these precursor lesions to noma requires infection by a consortium of micro-organisms, with Fusobacterium necrophorum (Fn) and Prevotella intermedia (Pi) as the suspected key players. Additional to production of a growth-stimulating factor for Pi, Fn displays a classic endotoxin, a dermonecrotic toxin, a cytoplasmic toxin, and a hemolysin. Without appropriate treatment, the mortality rate from noma is 70-90%. Survivors suffer the two-fold afflictions of oro-facial mutilation and functional impairment, which require a time-consuming, financially prohibitive surgical reconstruction.

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Fusobacterium necrophorum septicemia complicated by liver abscess

Cited by 27 publications

References 9 publications

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

Human Infection withFusobacterium necrophorum(Necrobacillosis), with a Focus on Lemierre's Syndrome

Oro-Facial Gangrene (Noma/Cancrum Oris): Pathogenetic Mechanisms

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