Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice

Epidemiology of pharyngeal carriage of Fusobacterium necrophorum

“…Tully et al (2006) have reported that adolescent students are at increased risk of meningococcal disease due to frequent intimate oral contact with multiple partners. The increased transmission of throat pathogens in this social group doubtless accounts for our finding of co-infection of F. necrophorum with EBV and b-haemolytic streptococci and may also explain the increased likelihood of asymptomatic carriage of F. necrophorum in this social group compared with the healthy non-student adults we have studied previously (Aliyu et al, 2004); 29 of the 411 students (7.1 %) were asymptomatic carriers compared with 0 of 100 (P50.01) in the previously studied healthy non-student adults.…”

“…Whilst our previous study (Aliyu et al, 2004) implied that finding F. necrophorum in the throat swab of a non-student indicated clinical infection, the same was not true for this predominantly adolescent student group, where the recovery of F. necrophorum did not necessarily indicate clinical infection (although some may have developed a sore throat later). However, we found that the magnitude of the copy count per swab of F. necrophorum may give an indication of the likelihood of active clinical infection; when we combined the F. necrophorum-positive students and F. necrophorum-positive GP patients we found that 7 out of 20 (35 %) subjects with a sore throat and without EBV or bhaemolytic streptococci had copy counts of 50 000 or more, whereas this finding only applied to 1 of 22 (4.6 %) asymptomatic subjects (P50.03, Fisher's exact test).…”

“…Throat swabs were tested for bhaemolytic streptococci by routine culture and Epstein-Barr virus (EBV) DNA and F. necrophorum by real-time PCR, employing laboratory methods described previously (Patel et al, 2003;Aliyu et al, 2004). In addition, the students completed a questionnaire for possible risk factors for throat infection.…”

Extensive thoracolumbosacral vertebral osteomyelitis after Lemierre syndrome

“…However, this period was insufficient in our patient and an additional 4.5 months of antibiotics was required to treat the recurrent multi-level vertebral osteomyelitis. Since penicillin treatment failures due to b-lactamase production have been described in the past, the initial treatment was already combined with clindamycin and metronidazol which are b-lactamase-resistant antibiotics with anaerobic activity [33,34]. Whether the initial treatment failure was due to further changes in Fusobacterium antibiotic resistance or due to the polymicrobial cause is unknown since the biopsie cultures remained negative.…”

A Sore Throat—Potentially Life-Threatening?

“…F. necrophorum is considered by some to be the second most common cause of bacterial sore throat after group A beta hemolytic streptococci. [1][2][3][4] Lemierre's syndrome, which also is known as postanginal septicemia and a form of necrobacillosis, was first reported by Lemierre in 1936. 5 Classic LS is characterized by four criteria, which include primary infection in the oropharynx, septicemia documented by at least one positive blood culture, clinical or radiographic evidence of internal jugular vein thrombosis, and at least one metastatic focus.…”