Fusobacterium invasive infections in children: a retrospective study in two French tertiary care centres

Abstract

The purpose of this investigation was to describe the clinical and biological characteristics and evolution of invasive Fusobacterium infections in children admitted to two French paediatric tertiary care centres. Children who were admitted from 1998 to 2009 to two tertiary care centres for invasive Fusobacterium infection were included in a retrospective study. Thirty-one children with a median age of 5.7 years (interquartile range, IQR [2.3; 9.3]) were included. Nine children had an underlying condition, most commonly sickle cell disease (n = 3) or immunodeficiency (n = 3). Two children had skin effraction prior to the infection. The major sites of infection were the head and neck (n = 14) and abdomen (n = 10). Three children suffered from atypical Lemierre's syndrome. More than half of the children had a bacterial co-infection (58 %). Six children were hospitalised in an intensive care unit, and 67 % of them had a chronic underlying disease. None of the children died. Six children with negative cultures had Fusobacterium identified through 16S RNA-PCR. Fusobacterium is responsible for severe infection in children. Microbiological diagnosis might be improved by the wider use of molecular detection.

Infections caused by Fusobacterium in children: a 14-year single-center experience

“…Other central nervous system complications were frequent in our series, including decreased level of consciousness at admission (22.7 %), meningitis (18 %) and CSVT (22.7 %). Interestingly, none of the children experienced seizures, compared with 3-30 % in other pediatric series [8,11]. Fusobacterium meningitis is rarely reported in the literature, mostly appearing in scattered case reports [18,27,28].…”

“…The true contribution of Fusobacterium can be questioned by the simultaneous presence of other pathogens in some cases (polymicrobial infections were observed in 27 % of the patients). In other series, however, polymicrobial infections were observed in up to half of cases with Fusobacterium infections [5,8]. Previous studies have demonstrated that the presence of Fusobacteria spp.…”

“…The majority of infections in children originate in the head and neck in other series too, with a rate of 45-70 % [8,11]. Abdominal infections are usually far more frequent in patients older than 50 years [5], although in one study 32 % of infections in children originated in abdomen [8].…”

“…Fusobacterium is known to be associated with abscess formation in adults (11-33 %) [2,5,6] and in children (3-53 %) [8,15] in different sites, including: peritonsillar, lungs, liver and others [2,9,16,24,25]. Brain abscesses, however, are rarely reported in other cohorts (0-3.2 %) [5,6,8,9,11,26], except in one, where epidural abscess developed in 4/7 (57 %) cases of Fusobacterium mastoiditis [15]. In our study, brain abscess developed in children with mastoiditis or sinusitis.…”

“…In 1936, André Lemierre described an association between primary infection with Fusobacterium and thrombosis of the internal jugular vein [7]. Current reports on the clinical diversity of infections in children are, however, scarce [4,8]. …”