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Adenotonsillar Conditions and Obstructive Sleep Apnoea
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
LS is a rare but potentially fatal complication of acute oropharyngeal (or ear) infection. It is characterised by suppurative thrombophlebitis of the internal jugular vein and metastatic abscesses (due to septic emboli). The causative organism is usually Fusobacterium necrophorum. LS should be suspected in patients with antecedent oropharyngeal infection, septic pulmonary emboli and pyrexia unresponsive to antimicrobials. Treatment is with antibiotics for 6 weeks and anticoagulation may be considered.
Bloodstream Infections
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Consider odontogenic source or intra-abdominal source. If Fusobacterium necrophorum is isolated, perform ultrasound duplex neck and throat inspection for Lemierre's syndrome (throat infection with peritonsillar abscess and infectious thrombophlebitis of the internal jugular vein).
Acute Otitis Media
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
A somewhat different incidence of organisms has been identified from those gained from culture in AOM. Around 20% of samples do not grow bacteria. Streptococcus pneumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa and Staphylococcus aureus are the most commonly reported in order of decreasing frequency. Haemophilus influenzae is less commonly reported, and Moraxella catarrhalis, Proteus mirabilis and Gram-negative anaerobes rarely. Fusobacterium necrophorum is also being increasingly implicated. Clinical features may vary in accordance with the pathogen isolated. Streptococcus pneumoniae appears to lead to more severe symptoms and a higher incidence of mastoidectomy, S. pyogenes causes less otalgia and Pseudomonas aeruginosa particularly affects children with ventilation tubes, with a less aggressive clinical course.50
Forget-me-not: Lemierre’s syndrome, a case report
Published in Journal of American College Health, 2023
Benjamin Silverberg, Melinda J Sharon, Devan Makati, Mariah Mott, William D Rose
Sore throat is one of the most common presenting concerns in a college health clinic. Without considering the pretest probability, many practitioners reflexively test for Streptococcal pharyngitis and mononucleosis, sometimes offering antibiotics even when a bacterial infection has not been proven. Table 1 offers an extensive, albeit not exhaustive, differential diagnosis for the adolescent patient with a sore throat. Viruses are canonically thought to be the most common etiology of pharyngitis overall (reportedly up to 90% of cases in adults). Symptomatic infections due to group A beta-hemolytic streptococci (GAS) are more common in children age 5-12 years, with a lower incidence in adults (except perhaps for those who directly care for children).7 Some clinician-researchers have argued that Fusobacterium necrophorum (FN) is a major – and less recognized – cause in adolescents.1,7 Confusing the matter further, bacterial infections may follow an initial viral infection. Missed diagnoses (and thereby incorrect treatment) and rare complications can prove fatal, as is the case with rheumatic fever and Lemierre’s syndrome. Unlike GAS, no bedside confirmatory test currently exists for FN and, further, the bacterium requires an anaerobic culture medium to grow.7
Growth rate alterations of human colorectal cancer cells by 157 gut bacteria
Published in Gut Microbes, 2020
Rahwa Taddese, Daniel R. Garza, Lilian N. Ruiter, Marien I. de Jonge, Clara Belzer, Steven Aalvink, Iris D. Nagtegaal, Bas E. Dutilh, Annemarie Boleij
Growth-inhibiting effects were mainly observed within the family Fusobacteriaceae (Figure 1 and Table 1). From the 12 out of 16 significant Fusobacteriaceae (81.3%) cells, 2 enhanced and 10 inhibited cellular growth. Fusobacterium necrophorum subsp. funduliforme 1_1_36S cells enhanced growth in HCT116, SW480, and HEK293T cells. Strikingly, while Fusobacterium nucleatum subsp. animalis 11_3_2 cells enhanced the growth of Caco-2 and HCT116, its secretome inhibited growth in those same cell lines. Especially the cell line HCT15 was sensitive to Fusobacteriaceae growth inhibition where 11 out of 16 strains significantly reduced growth rates. Alternatively, HEK293T and Caco-2 were less sensitive to Fusobacteriaceae with only four out of 16 strains inhibiting cell growth. Notably, the effect of Fusobacteriaceae secretomes on cell growth may be cell-specific depending on, for example, mutation status, since most secretomes that inhibited HCT116, SW480 and HCT15, did not inhibit the growth of Caco-2 and HEK293 T cells.
Lemierre’s syndrome treated operatively
Published in Baylor University Medical Center Proceedings, 2020
Allison T. Lanfear, Mohanad Hamandi, Joy Fan, Madison L. Bolin, Michael Williams, J. Michael DiMaio, John Waters
Lemierre’s syndrome (LS) is a severe sequela of an acute oropharyngeal infection, characterized by septic thrombophlebitis of the internal jugular vein (IJV) frequently complicated by metastatic infections.1–3 LS is most commonly caused by Fusobacterium necrophorum. The incidence of LS appears to be decreasing due to antimicrobial therapy; however, it affects 1 per 1 million and confers a mortality rate of up to 12%.4 Common presenting symptoms include prolonged pharyngitis, lateral neck pain, fever, shortness of breath, tachycardia, and hypotension.5,6 When promptly administered, antibiotics can be effective. However, complications may arise that require additional intervention. We report a case of LS in a young man, complicated by severe right-sided pleural effusion that resisted intrathoracic lytic treatment and required surgery.