title: Severe Fusobacteria infections (Lemierre syndrome) in two boys.
abstract: Abscess formation is a rare cause of febrile illness in childhood but always has to be considered in such clinical presentations. Belonging to the resident flora of the oropharyngeal region, Fusobacteria are known to cause local infections; from here they may extend to other sites via the bloodstream or are aspirated into the lung (Lemierre disease). We report on two boys with Lemierre disease due to infection by Fusobacteria in monoculture causing two different clinical phenotypes. Case 1 presented with a large subphrenic abscess and pneumonic infiltration of the right middle lobe. Primary focus of infection was periodontal disease. Case 2 presented with a life-threatening septicaemia due to a retropharyngeal abscess and perforated otitis media followed by osteomyelitis of the atlas and thrombosis of the left sigmoid sinus and internal jugular vein.
  
  
  CONCLUSIONS
  Fusobacteria should be considered in any abscess formation in children. A thorough examination of the oropharyngeal region as a possible site of primary manifestation is mandatory.
authors.affiliation: Department of Paediatrics and Paediatric Nephrology, University Children's Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany. lars.klinge@uni-essen.de
authors.forename: Lars
authors.initials: L
authors.lastname: Klinge
authors.forename: Udo
authors.initials: U
authors.lastname: Vester
authors.forename: Jörg
authors.initials: J
authors.lastname: Schaper
authors.forename: Peter F
authors.initials: PF
authors.lastname: Hoyer
mesh_terms: D000293:Adolescent; D001270:Cervical Atlas / Q000382:microbiology; D002648:Child; D004322:Drainage; D005674:Fusobacterium Infections / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D008439:Maxillary Diseases / Q000382:microbiology; D010019:Osteomyelitis / Q000382:microbiology; D010033:Otitis Media / Q000150:complications; D010510:Periodontal Diseases / Q000382:microbiology; D017703:Retropharyngeal Abscess / Q000382:microbiology*; D018805:Sepsis / Q000382:microbiology; D013369:Subphrenic Abscess / Q000382:microbiology*; D020246:Venous Thrombosis / Q000150:complications