Increased Diagnosis of Lemierre Syndrome and Other Fusobacterium necrophorum Infections at a Children’s Hospital

Abstract

ABSTRACT. Objective. To assess the apparent increase in the diagnosis of Lemierre syndrome (LS) and other Fusobacterium necrophorum infections at a large children's hospital. Infections with F necrophorum ranged from peritonsillar abscess to potentially fatal LS. LS is an oropharyngeal infection characterized by septic thrombophlebitis of head and neck veins, complicated by dissemination of septic emboli to pulmonary and systemic sites.Methods. Review of the medical and laboratory records was conducted of all patients who were seen at or admitted to the Children's Hospital of Wisconsin with the diagnosis of LS and/or isolation of F necrophorum from a clinical specimen between January 1995 and January 2002.Results. During the 7-year period of the study, there was an increase in the isolation of Conclusions. The cause for the recent increase in the number of serious infections caused by F necrophorum infection diagnosed at our institution is unclear but does not seem to be related to changes in microbiologic techniques or patient demography. We speculate that it could be attributable, in part, to alterations in antibiotic usage patterns in our region. Clinicians need to be aware of the increasing clinical importance of F necrophorum infections and the life-threatening nature of LS. Pediatrics 2003;112:e380 -e385. URL: http://www.pediatrics.org/cgi/ content/full/112/5/e380; Fusobacterium necrophorum, Lemierre syndrome, peritonsillar abscess, thrombophlebitis, pulmonary emboli.

Respiratory Failure and Hypercoagulability in a Toddler With Lemierre's Syndrome

“…[1][2][3][4][5][6] LS usually occurs in adolescents and young adults and may have a fulminant course even with proper antibiotic therapy. [2][3][4][5] Many clinicians are not familiar enough with this syndrome and its wide range of clinical presentations. 6 Some patients with F necrophorum bacteremia may complain of only a sore throat and have mild pharyngitis and fully recover with oral antibiotic therapy.…”

“…6 Some patients with F necrophorum bacteremia may complain of only a sore throat and have mild pharyngitis and fully recover with oral antibiotic therapy. 4 Others may present with a peritonsillar abscess or may be critically ill. [4][5][6][7][8] Our patient's condition deteriorated quickly, although his condition was diagnosed rapidly and he was started on appropriate antibiotic therapy.…”

“…3,4 Recently, an increased incidence of LS was reported in Wisconsin. 4 To the best of our knowledge, this is the youngest patient reported with LS. 4,6 Aside from his age, there were several other unique aspects in his presentation.…”

“…1 Since then, several dozen case reports have been published. [2][3][4][5][6][7][8] Most reported cases are in adolescents and young adults. Only a few patients under the age of 10 years have been reported.…”

Lemierre's syndrome presented with acute pancreatitis

“…It has been previously called “the forgotten disease” due to its drop in reported infections, but over the past 15 years there has been an increase in reported cases 5. In this modern era, the incidence is approximately 0.6–3.2 persons per million per year 2, 3, 6.…”