Isolation of Fusobacterium necrophorum from cancrum oris (noma).

Falkler, William A.; Enwonwu, Cyril O.; Idigbe, Emmanuel O.

doi:10.4269/ajtmh.1999.60.150

Cited by 70 publications

(74 citation statements)

References 83 publications

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“…Sampling of the oral tissues and lesions for microbiologic studies, as well as the methods used to identify the specific viruses and bacteria, have been reported in previous publications. 22,28 Biochemical studies. Sample collection.…”

Section: Methodsmentioning

confidence: 99%

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Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Enwonwu¹,

Falkler²,

Idigbe³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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105

129

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Abstract. This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (Ͻ 10.8 mol/L), retinol (Ͻ 1.05 mol/L), ascorbate (Ͻ 11 mol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. The nutrient deficiencies, in concert with previously reported widespread viral infections (measles, herpesviruses) in the children, would impair oral mucosal immunity. We postulate, subject to additional studies, that evolution of the oral mucosal ulcers including acute necrotizing gingivitis to noma is triggered by a consortium of microorganisms of which Fusobacterium necrophorum is a key component. Fusobacterium necrophorum elaborates several dermonecrotic toxic metabolites and is acquired by the impoverished children via fecal contamination resulting from shared residential facilities with animals and very poor environmental sanitation.

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Section: Methodsmentioning

confidence: 99%

“…27 Ongoing studies in Nigerian children indicate recovery of F. necrophorum from 88% of the noma lesions. 28 Prevotella intermedia, alpha-hemolytic streptococci, and Actinomyces spp. were isolated from 75%, 50%, and 38% of the patients, respectively.…”

mentioning

confidence: 99%

Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.

Enwonwu¹,

Falkler²,

Idigbe³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

Self Cite

105

129

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“…It can then progress to the syndrome described above with a prominent sign being neck pain, often unilateral. If not recognized and treated promptly and appropriately, suppurative thrombophlebitis and disseminated infection may develop with complications such as lung failure (septic emboli, pneumonia, acute (Vedire et al, 2007), pyomyositis (Crum-Cianflone & Mayer, 2008) and noma (Falkler et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Severe pneumonia and jaundice in a young man: an atypical presentation of an uncommon disease

Wingfield

Blanchard

Ajdukiewicz

2011

Journal of Medical Microbiology

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We present a patient with an atypical presentation of Fusobacterium infection, the genus responsible for Lemierre's syndrome. This syndrome, which often affects healthy, young people and can be fatal if not recognized and treated early, is defined as a history of recent oropharyngeal infection with clinical or radiological evidence of internal jugular vein thrombosis and isolation of anaerobic pathogens, mainly Fusobacterium necrophorum. The history, presentation, investigations and management of the patient are described and then contrasted with the existing literature surrounding Lemierre's syndrome, once termed the 'forgotten disease'. Case reportA previously fit and well 26-year-old male presented to hospital with a 3-day history of severe sore throat, general malaise, non-bloody diarrhoea, vomiting, fever and headache. He had no significant past medical history, did not take any medications and had no known allergies. He was an electric engineer who worked with air conditioning units and was an occasional drinker, a non-smoker and lived with his fiancé, their two children and a dog. He had no history of foreign travel and no risk factors for blood-borne viruses.On initial examination, the patient was clammy and febrile with jaundiced sclera. He had pharyngeal erythema and decreased air entry in the right lung base. Heart sounds were normal. He was tachycardic at 150 beats min 21 but normotensive. He was tender in the right upper quadrant and right lower quadrant with a 3 finger breadth palpable smooth liver edge. Neurological examination was normal.Initial blood tests revealed acute kidney injury with an estimated glomerular filtration rate of 32 ml min 21 , creatinine 207 mmol l 21 , urea 13.8 mmol l 21 and bicarbonate of 19 mmol l 21 . Leukocytes were raised with a neutrophilia and C-reactive protein was 258 mg l 21 . Haemoglobin was 14.9 g dl 21 , platelets 79610 9 l 21 and international normalized ratio 1.2. He had deranged liver function tests with a bilirubin level of 91 mmol l 21 , alanine aminotransferase 50 U l 21 , albumin 35 g l 21 and alkaline phosphatase of 128 U l 21 . Glucose was normal and blood cultures were sent. A chest radiograph showed patchy linear opacities in the right lower zone. An electrocardiogram showed sinus tachycardia.The initial diagnosis was community-acquired pneumonia. He was admitted under the medical team and treatment with intravenous fluids, co-amoxiclav and clarithromycin was initiated.The following day, the patient continued to be pyrexial, his oxygen requirements increased and he was referred to the Infectious Diseases team. On review, he had a PaO 2 of 10.14 kPa on 35 % FiO 2 with normal PCO 2 and pH, indicating type 1 respiratory failure with a wide arterial-alveolar gradient. Temperature was 40 u C and he remained tachycardic at 140 beats min 21 . He was noted to have pain in the right side of the neck with ipsilateral swelling on examination. Legionella and pneumococcal urinary antigen were negative. Renal function was improving but leukocytes and C-reactive pr...

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“…1 It is postulated that the disease is triggered by a consortium of micro organisms of which F�s��acteri�� necr��r�� is a key component. 2,8 Symbiotic relationship between fusiform bacilli and non-hemolytic streptococci and staphylococci has been considered a significant factor in the development of noma. Anaerobic bacteria may be present in rapidly progressing disease.…”

Section: Case Managementmentioning

confidence: 99%

“…It has been speculated that B�rrelia vincentii and F�s��acteri�� are prominent bacteria in such lesions. 2,8 Recent reports suggest that besides fusiform bacilli and spirochetes, other anaerobic bacteria are present in a relatively high proportion of noma lesions. 8 F. necr��r�� is considered a key component.…”

Section: Case Managementmentioning

confidence: 99%