Localised Fusobacterium necrophorum infections: a prospective laboratory-based Danish study

During a 3-year prospective laboratory-based study in Denmark from 1998 to 2001, all patients who were diagnosed with localised Fusobacterium necrophorum infections were registered with the purpose of describing the variety of localised infections caused by F. necrophorum, especially in the head. We found 267 patients, most of them previously healthy, with localised F. necrophorum infections in the head and neck. In children, F. necrophorum caused otitis media and solitary abscess formation in cervical lymphadenitis. In adolescents, F. necrophorum was found in 21% of peritonsillar abscesses. We also found F. necrophorum in young adults with tonsillitis and in middle-aged adults with sinusitis. F. necrophorum was found in substantial amounts and as the only bacterial pathogen in the majority of patients. All 267 patients recovered without sequelae. We found another 21 localised non-head-and-neck-associated F. necrophorum infections, mainly subcutaneous wound infections in adults. This study shows that F. necrophorum causes a variety of localised infections, especially in the head and neck region, with a characteristic age distribution. We recommend that anaerobic culture is performed on swabs from children with recurrent otitis media and adolescents with non-streptococcal group A tonsillitis.