Anaerobic Spondylodiscitis due to<i>Fusobacterium</i>Species: A Case Report Review of the Literature

Latta, Tiffany N.; Mandapat, Aimee Luna; Myers, Joseph P.

doi:10.1155/2015/759539

Cited by 4 publications

(7 citation statements)

References 29 publications

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“…Whereas a typical Lemierre’s syndrome consists of a septic cervical thrombophlebitis, usually complicated by septic emboli, atypical presentations have been reported in the abdomen, either in the context of genitourinary infections [8] or related to other intra-abdominal [9] or lower limb infections [5] (Table 1). Based on the absence of septic thrombophlebitis, these cases should be formally considered as different from bacteremia due to Fusobacterium [6, 10]. In our case, the presentation and evolution of Lemierre’s syndrome were atypical, as well as the identification of the less frequent F. nucleatum [8].…”

Section: Discussionmentioning

confidence: 83%

Atypical presentation of Lemierre’s syndrome: case report and literature review

2019

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BackgroundThe classic Lemierre’s syndrome refers to a septic thrombosis of the internal jugular vein, usually caused by a Fusobacterium necrophorum infection starting in the oral cavity, and typically complicated by pulmonary emboli. However, unusual forms of the disorder have been rarely reported.Case presentationWe describe an unusual case of a previously healthy 58-year-old male with Lemierre’s syndrome, manifesting with lumbar pain and fever. A thrombosis of the iliac veins and abscesses in the right iliac and the left psoas muscles was diagnosed by a computed tomography scan, together with a right lung pneumonia complicated by pleural effusion and an L4-L5 spondylodiscitis. Blood culture and pus drainage were positive for Fusobacterium nucleatum and an atypical Lemierre’s syndrome was suspected. The patient was treated with anticoagulant therapy for 12 weeks and intravenous antibiotic therapy for 6 weeks with a good evolution and resolution of the thrombosis.ConclusionsThis case illustrates the thrombogenic and thromboembolic tendency of Fusobacterium nucleatum and its potential invasiveness, regardless of the site of primary infection. The concept of an atypical Lemierre’s syndrome is redefined here to take into consideration non-cervical sites.

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Section: Discussionmentioning

confidence: 83%

Atypical presentation of Lemierre’s syndrome: case report and literature review

2019

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“…To our knowledge, only 18 cases of vertebral spondylodiscitis due to the Fusobacterium species have been described in the literature. [16][17][18] Of those, 12 cases were exclusively caused by F. nucleatum. In approximately 1/3 of cases, the diagnosis was based on the blood cultures and in 2/3 of the cases on disc aspirates.…”

Section: Case Reportmentioning

confidence: 99%

“…In some cases the oral pathology was completely asymptomatic and the correlation between the spinal infection and oral flora was made after the cultures. 17 The hallmark in the successful management of spinal spondylodiscitis is the isolation of the causative agent. Medical treatment remains the first-line management but the presence of neurological compromise with or without vertebral collapse and failure of conservative management are the two main indications for surgical treatment.…”

Section: Case Reportmentioning

confidence: 99%

“…In only 4 out of 18 cases, the treatment was surgical with open surgery to drain the abscess and/or to stabilise the spine performed. [16][17][18] We preferred the minimal invasive percutaneous biopsy and washout because of several reasons. 19 First, the amount of the pus in the most recent MRI was greater, giving us a confidence in achieving a good representative sample.…”

Section: Case Reportmentioning

confidence: 99%

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Rare, post-periodontitis spondylodiscitis caused byFusobacterium nucleatumin a patient with multiple sclerosis: challenge of diagnosis and treatment

et al. 2021

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Fusobacterium nucleatum is part of the commensal flora of the oral cavity, frequently associated with periodontal infections. We describe the case of a 49-year-old woman, on immunsuppressive therapy for multiple sclerosis, who presented with a 3-month history of debilitating back pain. She had a recent episode of periodontitis, and was under regular dental review. Her MRI scan demonstrated findings suggestive of L2–L3 spondylodiscitis. Her CT-guided biopsy yielded negative cultures and the patient failed two courses of empirical antibiotic treatment. With clinical and radiological disease progression, she underwent a percutaneous disc washout and biopsy, which subsequently grew F. nucleatum. Treatment with clindamycin and metronidazole was commenced orally for 6 weeks. She improved gradually, and at 1 year follow-up was asymptomatic. The diagnosis of spondylodiscitis caused by F. nucleatum is challenging. The perseverance on identification by surgical biopsy, minimally invasive washout and targeted antibiotics are the mainstay of effective treatment.

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“…Lemierre sendromu; internal juguler vende süpüratif tromboflebit, septik emboli, multipl organ disfonksiyonu, menenjit, venöz sinüs trombozu, artrit, osteomiyelit ile kendini gösteren bir sendromdur (7). Literatürde şimdiye kadar 16 hastada da Fusobacterium etkenli spondilodiskit rapor edilmiştir (8). Fusobacterium türleri daha çok oral flora bakterisi olmalarının da etkisiyle kraniyal ve fasiyal enfeksiyonlara neden olmaktadırlar (9).…”

Section: Cerrahi̇ Tekni̇kunclassified

Uzun Kemik Osteomiyelitinin Nadir Bir Etkeni: Fusobacterium necrophorum

Salduz¹,

Turgut²,

Bayram³

et al. 2016

Anadolu Kliniği Tıp Bilimleri Dergisi

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ÖzetOsteomiyelite yol açan patojenler çeşitlilik göstermekle birlikte, bağışıklığı baskılanmış hastalarda daha nadir görülen mikroorganizmalar da etken olabilmektedir. Bu çalışmada nadir bir vaka olarak, Fusobacterium cinsi bir bakterinin sebep olduğu osteomiyelitten muzdarip bir hastanın tanı ve tedavisini sunmayı amaçladık. 48 yaşındaki kadın hasta sol uyluğunda üç aydır mevcut olan ağrı ve şişlik şikayetiyle bize baş-vurdu. Çekilmiş olan MR görüntülerine göre malign kemik tümörü ön tanısı alarak kliniğimize sevk edilmişti. Hastanın skleroderma nedeniyle immünosüpresif ilaç kullanma hikayesi mevcuttu. İlk başvurudan iki gün sonra patolojik femur kırığı geçiren hastaya osteomiyelitin cerrahi tedavisi olarak apse drenajı, debridman ve kırık için de antibiyotikli sement kaplı intramedüller çivi ile osteosentez ameliyatı yapıldı. Ameliyat öncesinde alınan örneklerin kültüründe Fusobacterium necrophorum üredi. Yatışı sırasında vakum yardımlı kapama ile takip edilen hasta, akut faz reaktanları normale döndükten ve IV antibiyotik tedavisi tamamlandıktan sonra taburcu edildi. İmmün sistemi baskılanmış hastalarda Fusobacterium cinsi bakterilerin osteomiyelit etkeni olabileceği ve kemikteki litik lezyonların ayırıcı tanısında osteomiyelit olasılığı akılda tutulmalıdır. Anahtar Kelimeler: Fusobacterium necrophorum; osteomiyelit; sement kaplı çivi Abstract Although pathogens causing osteomyelitis vary, relatively uncommon microorganisms can cause osteomyelitis in immunosuppressed patients. In this study we aimed to present the diagnosis and treatment of a patient with a rare case of osteomyelitis due to infection with a species of Fusobacterium. A 48-year-old female patient complaining of swelling and pain in her left thigh for the last three months was referred to our clinic with a prediagnosis of bone malignancy based on the MRI findings. The patient had a history of immunosuppressive drug use for scleroderma. The patient suffered a pathological femoral fracture two days after her first visit to us. Abscess drainage and debridement were performed to treat her osteomyelitis, and an osteosynthesis including antibiotic cement-coated intramedullary nail insertion was performed for the fracture. Fusobacterium necrophorum grew in the culture of the preoperative specimens. The patient for whom vacuum-assisted closure was used during her hospitalization was discharged after the acute phase reactants returned to normal and the IV antibiotic treatment was completed. It should be noted that bacteria from the genus Fusobacterium can cause osteomyelitis in immunosuppressed patients, and that while making the differential diagnosis of the lytic lesions of bones osteomyelitis is one of the possibilities.

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Anaerobic Spondylodiscitis due toFusobacteriumSpecies: A Case Report Review of the Literature

Cited by 4 publications

References 29 publications

Atypical presentation of Lemierre’s syndrome: case report and literature review

Atypical presentation of Lemierre’s syndrome: case report and literature review

Rare, post-periodontitis spondylodiscitis caused byFusobacterium nucleatumin a patient with multiple sclerosis: challenge of diagnosis and treatment

Uzun Kemik Osteomiyelitinin Nadir Bir Etkeni: Fusobacterium necrophorum

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