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  • Title: Clinical spectrum of bacteraemic Fusobacterium infections: from septic shock to nosocomial bacteraemia.
    Author: Nohrström E, Mattila T, Pettilä V, Kuusela P, Carlson P, Kentala E, Mattila PS.
    Journal: Scand J Infect Dis; 2011 Jul; 43(6-7):463-70. PubMed ID: 21391770.
    Abstract:
    BACKGROUND: Fusobacterium species are anaerobic bacteria that relatively rarely cause sepsis with a variable clinical presentation. METHODS: We reviewed the records of 52 consecutive patients who had Fusobacterium bacteraemia over a 10-y period. RESULTS: The clinical pictures could be classified into 4 groups: (1) patients who had Lemierre's syndrome with Fusobacterium necrophorum sepsis and internal jugular vein thrombosis, n = 5 (10%); (2) previously healthy patients who had F. necrophorum sepsis without any signs of macroscopic vascular thrombosis (but 5 of them had abscesses), n = 14 (27%); (3) women who had puerperal infections, n = 6 (12%); and (4) patients who were on average older than the patients in the previous groups, who had cardiovascular, pulmonary, neoplastic, or other underlying diseases, n = 27 (52%). Of these latter 27 patients, 23 had nosocomial Fusobacterium nucleatum bacteraemia presenting as a febrile illness associated with chemotherapy or instrumentation. CONCLUSIONS: Patients with chronic underlying diseases are more likely to be infected with F. nucleatum than F. necrophorum. F. nucleatum bacteraemia may present as a febrile illness without severe symptoms. F. necrophorum caused sepsis mainly in previously healthy individuals. These infections may be accompanied with a jugular vein thrombosis characteristic of Lemierre's syndrome and septic shock. However, F. necrophorum infections present more frequently without any apparent venous thrombosis and may be accompanied by abscesses.
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