Increased diagnosis of Lemierre syndrome and other Fusobacterium necrophorum infections at a Children's Hospital.
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 F necrophorum from patients who were seen at Children's Hospital of Wisconsin, as well as the number of cases of LS. There was 1 isolation of F necrophorum from clinical specimens per year from 1996 to 1999, which increased to 10 isolates of the organism from January 2000 to January 2002. During the most recent period, January 2001-January 2002, 5 cases of LS were diagnosed, a distinctive entity not recognized previously at the institution.


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.
Department of Internal Medicine, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee 53226, USA.
Susan
S
Ramirez
Tannaz G
TG
Hild
Colin N
CN
Rudolph
John R
JR
Sty
Susan C
SC
Kehl
Peter
P
Havens
Kelly
K
Henrickson
Michael J
MJ
Chusid
D000293:Adolescent; D002648:Child; D005260:Female; D005674:Fusobacterium Infections / Q000453:epidemiology*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007601:Jugular Veins; D008297:Male; D000039:Peritonsillar Abscess / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D011655:Pulmonary Embolism / Q000209:etiology; D012189:Retrospective Studies; D013577:Syndrome; D013924:Thrombophlebitis / Q000209:etiology / Q000382:microbiology; D014922:Wisconsin / Q000453:epidemiology