Infections caused by Fusobacterium in children: a 14-year single-center experience.
OBJECTIVE
This study aimed at reviewing our experience with infections caused by Fusobacterium in children.


METHODS
A retrospective analysis of medical records of children admitted to Hadassah-Hebrew University Medical Center from 2000 to 2013, in whom Fusobacterium spp. was identified in any specimen.


RESULTS
A total of 22 patients (males = 12) at a mean ± SE age of 5 ± 1 (range 1-17) years, were identified. The most common complication was abscess formation (n = 11, 50 %). Eight children (36.4 %) had intracranial complications, including brain abscess (n = 4), meningitis (n = 4) and cerebral sinus vein thrombosis (CSVT, n = 5). Seventeen children (77 %) had bacteremia. Primary site of infection was otogenic (n = 9), oropharyngeal (n = 7), respiratory (n = 2), sinuses (n = 2), intra-abdominal (n = 1) and mucositis (n = 1). Fourteen cases were caused by Fusobacterium necrophorum, including four cases with CSVT, 7/8 cases of mastoiditis, four of them with subperiosteal abscess formation; all four cases with meningitis and two brain abscesses. Fifteen (68 %) patients required surgical intervention and 3 (14 %) received anti-coagulation therapy. Excluding one patient with overwhelming sepsis with fatal outcome, all patients recovered.


CONCLUSIONS
Fusobacterium infections in children can cause a diverse spectrum of disease and is associated with high rates of abscess formation and intracranial complications. Although Fusobacterium nucleatum is abundant in the oral cavity, F. necrophorum is the main pathogen that causes severe infections in healthy children.
Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Oded
O
Shamriz
Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.|Pediatric Infectious Diseases Unit, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Dan
D
Engelhard
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Violeta
V
Temper
Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Shoshana
S
Revel-Vilk
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Shmuel
S
Benenson
Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Rebecca
R
Brooks
Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Ariel
A
Tenenbaum
Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Polina
P
Stepensky
Department of Medical Imaging, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Benjamin
B
Koplewitz
Department of Otolaryngology/Head & Neck Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Michal
M
Kaufmann
Pediatric Division, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel. dina8282@walla.co.il.|Pediatric Infectious Diseases Unit, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel. dina8282@walla.co.il.
Diana
D
Averbuch
D000038:Abscess / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005674:Fusobacterium Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies
Bacteremia; Clinical spectrum; Complications; Fusobacterium; Lemierre; Otogenic infections