Acute Otitis Media
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
This has an estimated incidence of 0–2.7%58 and most commonly results from erosion of the bone over the sinus from mastoiditis, and may also be associated with other complications. However, it occurs in association with otitis media alone in 43% of cases. Infected thrombus develops within the sinus and may then extend proximally and distally to the internal jugular vein and superior vena cava, entering the systemic circulation and causing septicaemia. In addition to headache and otorrhoea, a spiking pyrexia may develop. Griesinger’s sign is mastoid tenderness and oedema secondary to thrombophlebitis of the mastoid emmisary vein. The presence of specific neurological signs and symptoms is significantly correlated with hypoplasia of the contralateral venous sinus and may be absent in up to 50% of children. The presence of Fusobacterium necrophorum dictates a more aggressive and prolonged clinical course. MRI is the imaging of choice showing an acute clot as isodense on T1 and hypodense on T2, with a subacute clot becoming hyperintense on T1. The addition of MR venography will demonstrate lack of flow and increase the sensitivity of the diagnosis especially in the early stage.
Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Fred W Wright in Radiology of the Chest and Related Conditions, 2022
The anaerobe Fusobacterium necrophorum may occasionally give rise to a severe septicaemia, with lung consolidation, breakdown and cavitation. The condition should be considered in previously healthy adolescents and adults who develop a severe septicaemic illness with prominent symptoms after an initial sore throat. The presenting features are usually characteristic and were described in detail by Lémierre (1936), his name often being given to the condition. It can easily be confused with staphylococcal septicaemia, but the latter is not usually preceded by a sore throat. Affected patients may have painful submandibular lymphadenopathy. Untreated the illness is mostly fatal.
Infectious diseases
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Bacterial sore throat – complications:1 Lemierre’s disease (caused by Fusobacterium necrophorum).2 Acute rheumatic fever.3 Acute glomerulonephritis.4 Skin (scarlet fever; guttate psoriasis).
Associations of the gut microbiome with hepatic adiposity in the Multiethnic Cohort Adiposity Phenotype Study
Published in Gut Microbes, 2021
Meredith A. J. Hullar, Isaac C. Jenkins, Timothy W. Randolph, Keith R. Curtis, Kristine R. Monroe, Thomas Ernst, John A. Shepherd, Daniel O. Stram, Iona Cheng, Bruce S. Kristal, Lynne R. Wilkens, Adrian Franke, Loic Le Marchand, Unhee Lim, Johanna W. Lampe
Oral bacteria have been implicated in inflammation-based diseases (e.g., cardiovascular disease, T2D, colorectal cancer (CRC), and NASH).84,85 We observed a higher abundance Fusobacterium, Aggregatibacter, and Alloprevotella in participants presenting with NAFLD, which varied by ethnicity (Figure 2). In our study, Alloprevotella was significantly increased in whites with NAFLD and others have Alloprevotella enriched in liver biopsies in subjects with NAFLD.70Aggregatibacter has been associated with NAFLD and altered glucose metabolism.46,47Fusobacterium was significantly decreased in African Americans with NAFLD (Figure 2, Supplemental Figure 4). In contrast, whites with NAFLD showed a significant enrichment in Fusobacterium and a higher percentage of whites had Fusobacterium in their stool (Figure 2, Supplemental Figure 4). Fecal enrichment in stool of the oral pathogen Fusobacterium, has been associated with NAFLD and with inflammation and fibrosis in NASH.12,61,86 The clinical relevance of Fusobacterium may be as an alterable prognostic marker linked to prevention through changes in periodontal and oral hygiene.87
Adjuvant use of combination of antibiotics in acute severe ulcerative colitis: A placebo controlled randomized trial
Published in Expert Review of Anti-infective Therapy, 2021
Shubhra Mishra, Harshal S Mandavdhare, Harjeet Singh, Arup Choudhury, Jimil Shah, Sant Ram, Dimple Kalsi, Jayanta Samanta, Kaushal K Prasad, Arun K Sharma, Usha Dutta, Vishal Sharma
Improvement with antibiotics has been noted in some retrospective studies and with use of oral antibiotics in the setting of mild to moderate UC and in pediatric ASUC [9,11,18,19]. There has been a suggestion that use of targeted therapy for Fusobacterium may be beneficial in the setting of active UC. A Japanese group has demonstrated that Fusobacterium varium was present in a higher number of patients with active UC and that this organism had an ability to invade colonic epithelium and induce inflammation [20,21]. Further, a cocktail of antibiotics (Amoxicillin, Tetracycline, and Metronidazole) was demonstrated to be effective in active UC [9]. This is partly the reason for the choice of our combination. We used antibiotics (ceftriaxone and metronidazole) which cover gram negative enteric infections (E Coli, Campylobacter, Shigella, Salmonella), anaerobic, and protozoal infections like amebiasis. Additionally, ceftriaxone and metronidazole are also recognized to have activity against Fusobacterium varium. However, similar to the three previous RCTs evaluating the use of intravenous antibiotics in adult patients with ASUC, our results have not shown benefit of this intervention. Mantzaris et al. evaluated the role of intravenous tobramycin and intravenous metronidazole in one trial, and of intravenous ciprofloxacin in another. In both the trials, the use of adjuvant antibiotics showed no added benefit [22,23]. Another trial conducted by Chapman et al. used adjuvant intravenous metronidazole in patients in ASUC and did not find any advantage of using the same [24]. In wake of these data, and lack of studies from tropical countries, our study adds to the evidence of lack of benefit of intravenous antibiotics in ASUC. Further, unwarranted use of antibiotics not only alters the gut microbiome, but it is well recognized to increase risk of development of antimicrobial-resistant strains and CDI.
Lemierre’s syndrome with muscle necrosis and chronic osteomyelitis
Published in Baylor University Medical Center Proceedings, 2021
Azka Latif, Muhammad Junaid Ahsan, Amman Yousaf, Asim Tameezuddin, Akshat Sood, Joseph Thirumalareddy
The diagnosis of LS is made by clinical, laboratory, and radiological investigations. Determining the presence of thrombus in the vessels usually requires ultrasound and contrast-enhanced computed tomography. On ultrasound, our patient had an acute thrombus in the left internal jugular vein. In laboratory investigations, Fusobacterium can be isolated from blood or tissue cultures.10
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