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PubMed1999

Lemierre's syndrome.

Postanginal sepsis, or Lemierre's syndrome, is rare but with life-threatening potential involving mainly infants and adolescents. The morbidity or mortality is caused mainly by lack of knowledge of the syndrome. The 18-year-old boy described here developed a jugular thrombosis 7 days after an angina. Fusobacterium necrophorum was isolated from the culture of the excised jugular vein. Secondary embolism involved the lungs, associated with an iliac osteomyelitis and sacroiliitis. Computed tomography was used for diagnosis and follow-up.

Adolescent↗
PubMed2004

Lemierre's syndrome: three cases and a review.

Postanginal sepsis, also called Lemierre's syndrome, is a rare but acute medical condition complicating oropharyngeal infection. The pathogenesis consists of the development of internal jugular vein septic thrombophlebitis leading to metastatic infections in the lung and other sites. The causative microorganism is most often Fusobacterium necrophorum. We present three patients with Lemierre's syndrome who presented to the Leiden University Medical Center and give a review of the literature.

Adolescent↗
PubMed2006

Pyogenic infections of the central nervous system secondary to dental affections--a report of six cases.

Pyogenic infections of the central nervous system of dental origin are quite uncommon in industrialized countries. We report six cases with intracerebral (n = 4) and intraspinal (n = 2) infections treated in our hospital. The microbial pathogen was successfully isolated in all patients. Fusobacterium nucleatum as well as Streptococcus species were found in three cases. Bacillus species were identified in two patients. Actinomyces was the etiologic agent in one case. All patients suffered from dental pathologies, so that after clinical and radiological exclusion of other sources an oral focus was presumed. Therapeutic management consisted of an operative procedure in order to obtain decompression, as well as evacuation of the pus on the one hand, followed by targeted antibiotics on the other. Clinical improvement was achieved in all patients, with one patient lost to follow-up. On magnetic resonance tomography, the inflammatory changes also disappeared in all cases. We recommend that oral infection with recurrent bacteraemia should always be considered in the pathogenesis of the so-called "cryptic" intracerebral and intraspinal infections.

Abscess↗
PubMed1990

A rabbit model for bacteria-induced preterm pregnancy loss.

Bacterial infection has been implicated in premature labor in humans. To elucidate mechanisms and potential intervention strategies, we sought to develop a model of infection-induced pregnancy loss in rabbits. On day 21 (70% of gestation), each uterine horn was inoculated hysteroscopically with 0.2 ml containing saline solution of 10(6) cfu Escherichia coli or Bacteroides bivius or Fusobacterium necrophorum. Fetal viability was assessed. Animals were sacrificed at various times or as delivery occurred. Serum progesterone and amniotic fluid prostaglandins were measured. Cultures and histologic sections were prepared. Compared with the saline solution group, E coli and F. necrophorum-inoculated rabbits were significantly more likely to deliver (16 of 16 and six of seven with mean times of 31.9 +/- 10.7 and 28.3 +/- 11.5 hours, respectively for E. coli and F. necrophorum). Positive amniotic fluid cultures for the E. coli group were found in 11 of 12 (92%) and for the F. necrophorum group in three of three cases (100%). Histologic inflammation was seen heavily in both the E. coli and F. necrophorum groups, whereas it was absent in the saline solution group. Inoculation with B. bivius led to a much lower pregnancy loss rate (eight of 32) and less histologic inflammation despite positive uterine cultures in most animals. This model may provide an opportunity to determine mechanisms of clinical or subclinical intraamniotic infection and to test intervention strategies.

Abortion, Septic↗
PubMed1992

Summer mastitis in heifers: studies on the seasonal occurrence of Actinomyces pyogenes, Peptostreptococcus indolicus and Bacteroidaceae in clinically healthy cattle in Denmark.

With the aim of investigating the seasonal occurrence of Actinomyces pyogenes, Peptostreptococcus indolicus, Bacteroides melaninogenicus ss. levii and Fusobacterium necrophorum, and thus the potential for development of summer mastitis, clinically healthy Danish Holstein-Friesian heifers due to calve in the autumn were sampled from the teat tip, the conjunctiva and the oral cavity at 2-6 week intervals from 1979 to 1981. The overall isolation rates of F. necrophorum, P. indolicus and B. melaninogenicus ss. levii, in order of significance, were significantly higher during the pasture period whereas no differences in isolation rates of A. pyogenes between housed and pastured animals were detected. F. necrophorum was recovered almost exclusively from the oral cavity, P. indolicus and A. pyogenes occurred most frequently in samples from the teat skin, whereas isolates of B. melaninogenicus ss. levii were evenly distributed between conjunctiva and teat tip samples. A distinct seasonal pattern of the isolation rates of summer mastitis pathogens was recorded, which corresponded closely to the seasonal activity of symbovine insects, in particular the headfly Hydrotaea irritans (Fallén). However, the high proportion of clinically healthy bacterial carriers as compared with the incidence of clinical disease strongly suggests that as yet unknown contributing or triggering factors, apart from the mere presence of the relevant bacterial species, are required for the establishment and development of clinical summer mastitis.

Actinomycosis↗
PubMed2004

Effect of intrauterine administration of oestradiol on postpartum uterine bacterial infection in cattle.

After parturition fewer first dominant follicles are selected in the ovary ipsilateral to the previously gravid uterine horn in cattle. However, the presence of a large oestradiol-secreting follicle in the ipsilateral ovary is a predictor of fertility, possibly due to a localised effect of oestradiol which increases the rate of elimination of the ubiquitous uterine bacterial contamination that occurs after calving. The present study tested the hypothesis that oestradiol reduces uterine bacterial contamination when administered into the uterine lumen around the expected time for selection of the first postpartum dominant follicle. Animals were infused with saline (n=15) or 10mg oestradiol benzoate (n=15) into the previously gravid uterine horn on Days 7 and 10 postpartum. Peripheral coccygeal blood samples were collected daily and oestradiol concentrations measured by radioimmunoassay (RIA). Uterine lumen swabs were collected 7, 14 and 21 days postpartum for aerobic and anaerobic culture, bacteria were identified and growth scored semi-quantitatively. Plasma oestradiol concentrations were higher for treated animals between Days 7 and 14 (1.4+/-0.1 versus 2.0+/-0.2 pg/ml, P<0.05). Control animals had a similar bacterial growth score on Days 7 and 14, with a lower value on Day 21 (5.7+/-1.0 and 6.1+/-0.7 versus 0.3+/-0.1, P<0.05). However, treated animals had a surprising higher bacterial load on Day 14, than on Days 7 or 21 (7.1+/-0.9 versus 4.0+/-0.6 or 3.6+/-0.6, P<0.05). The increased score was attributable to more pathogens associated with endometritis on Day 14 than Day 7 (5.1+/-1.0 versus 2.5+/-0.5, P<0.05), in particular Prevotella melaninogenicus (1.5+/-0.5 versus 0.7+/-0.2, P<0.05) and Fusobacterium necrophorum (1.5+/-0.4 versus 0.3+/-0.2, P<0.05). In conclusion, administration of oestradiol into the uterine lumen surprisingly increased uterine pathogenic anaerobic bacterial contamination. Thus, it is unlikely that increased fertility associated with a first dominant follicle in the ipsilateral ovary is a consequence of the elimination of bacterial contamination by ovarian oestradiol.

Animals↗
PubMed2005

Lemierre syndrome.

Lemierre syndrome is a disease that presents with oropharyngeal infection, sepsis, internal jugular vein thrombosis, and septic emboli with the Gram-negative organism Fusobacterium necrophorum cultured as the etiologic agent. Clindamycin, metronidazole and ampicillin-sulbactam are effective antibiotic treatments, although the length of treatment has not been firmly established. The syndrome is seen less frequently in the current age of antibiotics. It is important, however, that physicians be aware of the syndrome as initiation of prompt antibiotic therapy, including anaerobic coverage, is essential for avoiding morbidity and mortality. We describe a case of Lemierre syndrome.

Adolescent↗
PubMed2004

Cerebral infarct and meningitis secondary to Lemierre's syndrome.

The case is reported of a young man with Fusobacterium necrophorum septicemia who developed cavernous sinus thrombosis, meningitis, carotid artery stenosis and stroke. This article presents the only reported case of arterial stroke in Lemierre's syndrome. Clinical presentation, diagnostic difficulty and treatment are discussed.

Adolescent↗
PubMed2006

[Lemierre's syndrome: literature review].

OBJECTIVES: Our aim was to recall the pathogenesis, clinic aspects and therapeutic options for Lemierre's syndrome. PATIENTS AND METHODS: This was a retrospective study (1998-2005) of 4 patients, 3 males and 1 female, average age 22 years (18-30). Bacteriological samples, a chest radiograph and a cervical and thoracic CT-scan with injection were available for all patients who were given broad spectrum antibiotic therapy for 3 to 6 weeks. Surgical treatment was necessary for 3 patients. A review of the literature from Medline was performed. RESULTS: Three patients had a peritonsillar abscess. All of them exhibited thrombophlebitis of the internal jugular vein or one of its tributary branches. In all patients, metastatic infections were noted. In one, arthritis and mediastinitis were associated. The causal microorganism was Fusobacterium (necrophorum--2, nucleatum--1) in three patients. In one, bacteriological samples were negative. Transfer to an intensive care unit was necessary for one patient. There were no deaths. CONCLUSIONS: Lemierre's syndrome is a rare but acute medical condition which concerns young immunocompetent people. The pathogenesis consists of the development of infectious thrombophlebitis in the internal jugular vein or one of its tributary branches caused by a focal sepsis, localized in most the cases in the oropharynx, leading to metastatic infections, generally to the lung. Treatment is medical but surgery is sometimes required.

Adolescent↗
PubMed1998

Sinusitis in neurologically impaired children.

The microbiologic features of infected sinus aspirates in nine children with neurologic impairment were studied. Anaerobic bacteria, always mixed with aerobic and facultative bacteria, were isolated in 6 (67%) aspirates and aerobic bacteria only in 3 (33%). There were 24 bacterial isolates, 12 aerobic or facultative and 12 anaerobic. The predominant aerobic isolates were Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus (2 each) and Proteus mirabilis, Pseudomonas aeruginosa, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae (1 each). The predominant anaerobes were Prevotella sp. (5), Peptostreptococcus sp. (4), Fusobacterium nucleatum (2), and Bacteroides fragilis (1). Beta-lactamase-producing bacteria were isolated from 8 (89%) patients. Organisms similar to those recovered from the sinuses were also isolated from tracheostomy site and gastrostomy wound aspirates in five of seven instances. This study demonstrates the uniqueness of the microbiologic features of sinusitis in neurologically impaired children, in which, in addition to the organisms known to cause infection in children without neurologic impairment, facultative and anaerobic gram-negative organisms that can colonize other body sites are predominant.

Adolescent↗
PubMed2001

Lemierre's syndrome. Sepsis complicating an anaerobic oropharyngeal infection.

Previously healthy people without interfering conditions are rarely affected by anaerobic infections. We report a young patient with extended septic emboli in the lungs, after an episode of sore throat, due to anaerobic bacteremia with Fusobacterium necrophorum. The first description of oropharyngeal infection complicated by sepsis was given by Lemierre in 1936. Knowledge of Lemierre's syndrome should lead to early recognition and prompt action against this sporadic and possible fatal illness.

Adolescent↗
PubMed1985

Laminitis and interdigital dermatitis and heel horn erosion. A European perspective.

Laminitis is one of the most important claw disorders in dairy herds. Nutrition, calving, burdening of the lateral claw of the rear feet, and hereditary susceptibility are all contributing factors. Interdigital dermatitis in cattle may be a result of infection by Bacteroides nodosus and Fusobacterium necrophorum. If this infection becomes chronic, heel horn erosion is its consequence.

Animal Nutritional Physiological Phenomena↗
PubMedDate not supplied

Lemierre's syndrome presenting as multiple lung abscesses.

Lemierre's syndrome is thrombophlebitis of the internal jugular vein (IJV), complicating an oropharingeal infection. The causative organism is Fusobacterium, an anaerobic bacillus, and the syndrome typically occurs in previously healthy teenagers and young adults. Thromboembolic metastases are a common sequela, and the lungs are most frequently affected. We present a case of a 25-year-old woman, who presented with multiple lung abscesses, in whom IJV thrombophlebitis was subsequently noted.

Adult↗
PubMed2003

Bacteriological study of root canals associated with periapical abscesses.

OBJECTIVE: The aim of this study was to identify microorganisms from root canals with periapical abscesses and to ascertain the susceptibility of Peptostreptococcus prevotii and Fusobacterium necrophorum to antimicrobials. Study design Thirty root canals were microbiologically sampled by using sterile paper points. The concomitant microorganisms were identified through the use of established methods. The susceptibility of P prevotii and F necrophorum to antimicrobials was evaluated by using the E test method. RESULTS: A total of 117 different bacterial strains were recovered, including 75 strict anaerobes or microphilic species. The most frequently isolated strict anaerobes were P prevotii, Peptostreptococcus micros, and F necrophorum. Facultative bacteria such as Gemella morbillorum and Streptococcus mitis were also found, albeit less frequently. The data revealed that P prevotii and F necrophorum were susceptible to the tested antibiotics. CONCLUSIONS: Gram-positive anaerobic bacteria predominate in the mixed microbiota of root canals with periapical abscesses. Moreover, P prevotii and F necrophorum are susceptible to the tested antibiotics.

Adolescent↗
PubMed1989

Necrobacillosis and immunity in mice.

The study arose from the recent finding that sub-lethal numbers of certain bacterial species greatly enhanced the infectivity of Fusobacterium necrophorum. A severe F. necrophorum infection in mice, cured with metronidazole, produced significant though slight resistance, which was demonstrable by challenge with a minute dose of F. necrophorum (less than 20 organisms) suspended in a sub-lethal dose of Escherichia coli (300 x 10(6) organisms) to enhance fusobacterial infectivity. In an earlier comparable experiment, challenge with F. necrophorum alone, in necessarily large doses (greater than or equal to 3 x 10(6) organisms), failed to demonstrate that a single cured fusobacterial infection gave rise to resistance; such an infection neither protected against the fatal necrobacillosis produced by challenge nor prolonged survival. A sub-lethal E. coli infection was also shown by challenge with a minute dose of F. necrophorum (less than 10 organisms), suspended in a sub-lethal dose of E. coli (152 x 10(6) organisms), to produce significant though slight protection against necrobacillosis. The degrees of resistance demonstrated were too slight to give any encouragement to the prospect of an effective necrobacillosis vaccine.

Animals↗
PubMed1990

Experimental observations on the pathogenesis of necrobacillosis.

Earlier studies showed that the minimum infective dose (greater than 10(6) organisms) of a virulent strain of Fusobacterium necrophorum could be greatly reduced by suspending the fusobacteria in sub-lethal doses of cultures of other bacteria such as Escherichia coli before inoculating mice subcutaneously. In the present study the infective dose of the same strain of F. necrophorum was reduced by a factor of greater than 10(3) by suspending the fusobacteria in sub-lethal doses of 5% homogenate of gaur or wallaby faeces. Sterile faecal filtrate had no such effect. The sites of low grade infection produced by the prior subcutaneous injection of E. coli culture or gaur faecal suspension were susceptible to superinfection by doses of F. necrophorum far below those required to infect normal tissue. This work helps to explain the production of necrobacillosis by the faecal contamination of small wounds. It proved impossible, however, to produce necrobacillosis in mice by the subcutaneous injection of faecal suspensions from 33 farm cattle. This suggests that the proportion of cattle with virulent F. necrophorum in their faeces is low.

Animals↗
PubMed2002

Cytokine production in response to endodontic infection in germ-free mice.

This study evaluated the cytokine profiles (type 1 or type 2) that are triggered by and modulate endodontic periapical infections in the root canal system of germ-free mice. Microorganisms isolated from two patients with pulpal necrosis were inoculated into two groups of experimental animals: group I (Gemella morbillorum) and group II (Bifidobacterium adolescentis, Fusobacterium nucleatum and Clostridium butyricum). In vitro, G. morbillorum induced type 1 cytokine synthesis, while the modulation processed in vivo seemed to have the opposite effect, with a reduction in the basal levels of IL-12 and IFN-gamma, IL-4-independent down-modulation. In vitro, microorganisms from group II, in poly-infection, induced a reduction of type 1 cytokine levels from day 10 to day 20, which seemed to be modulated via IL-4. In vivo, however, a predominance of the immune response to one species over the others occurred.

Animals↗
PubMed2002

Direct amplification of rRNA gene sequences for identification of selected oral pathogens in root canal infections.

AIM: The purpose of this study was to assess the prevalence of selected oral pathogens in root canal infections and their relationship with symptoms using a highly sensitive technique, the polymerase chain reaction. METHODOLOGY: Samples were obtained from 91 infected teeth associated with periradicular lesions, including cases of acute periradicular abscesses. DNA was extracted from the samples and analysed for the presence of target microbial species using a PCR-based identification assay. RESULTS: All samples were positive for the presence of bacteria. Streptococcus anginosus group was detected in 16.7%, Fusobacterium nucleatum in 14.3%, and Bacteroides forsythus in 7.1% of the abscess samples. No pus sample yielded Actinomyces israelii, Actinobacillus actinomycetemcomitans or fungal species. In general, B. forsythus was found in 20% of the cases (16 of 80), S. anginosus in 12% (6 of 50), F. nucleatum in 10% (6 of 60) and A. israelii in 5% (two of 40). A. actinomycetemcomitans was not detected in any case. Fungi were present in only one of 50 cases (2%). There was no correlation between the species and symptoms. CONCLUSIONS: Direct molecular approaches appear to be a valuable tool for the rapid and reliable diagnosis of infectious diseases, as well as for research purposes. There was no correlation between target microbial species and symptoms.

Actinomyces↗