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Necrobacillosis
1Department of Microbiology, St Thomas' Hospital, London, United Kingdom.
Abstract:
Fusobacterium necrophorum, an anaerobe for which numerous synonyms exists, causes a severe septicaemic illness in man. This, in common with various animal infections with the organism, has been called necrobacillosis. These septicaemias usually occur in previously healthy children and adolescents. A total of 45 cases were studied from over 20 hospitals in England and Wales. The commonest presentation (two thirds of cases) was of post-anginal septicaemia, in which a sore throat was followed by rigors and metastatic abscesses, usually in the lung, but also in bone, central nervous system and other sites. Multisystem disturbance was frequent. Other cases presented without a previous sore throat but with otitis, mastoiditis, sinusitis or dental infection, or with acute osteomyelitis. Two patients died of their infection. In those who survived, recovery was usually prolonged, despite appropriate antibiotics. In many cases there was considerable diagnostic confusion, and few doctors were familiar with the disease. F. necrophorum was often initially misidentified in the laboratory. Necrobacillosis is a serious, if uncommon, infection of healthy young people, it deserves wider recognition.
Insights
Necrobacillosis, a severe illness caused by Fusobacterium necrophorum, primarily affects healthy children and adolescents. This infection often presents as post-anginal septicaemia with metastatic abscesses, requiring prolonged recovery.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Fusobacterium necrophorum causes necrobacillosis, a severe septicaemic illness.
- This infection predominantly affects healthy children and adolescents.
- Necrobacillosis is often misdiagnosed and under-recognized.
Purpose of the Study:
- To describe the clinical presentation and outcomes of necrobacillosis.
- To highlight diagnostic challenges associated with Fusobacterium necrophorum infections.
- To emphasize the need for greater recognition of this serious condition.
Main Methods:
- A retrospective study of 45 cases of necrobacillosis.
- Data collected from over 20 hospitals in England and Wales.
- Analysis of clinical presentations, diagnostic procedures, and patient outcomes.
Main Results:
- Post-anginal septicaemia was the most common presentation (two thirds of cases).
- Metastatic abscesses occurred frequently, commonly in the lungs, but also in bone and CNS.
- Multisystem disturbance was frequent; mortality was low but recovery prolonged.
- Diagnostic confusion and laboratory misidentification of F. necrophorum were common.
Conclusions:
- Necrobacillosis is a serious, albeit uncommon, infection in young individuals.
- Wider recognition by clinicians and improved laboratory identification are crucial.
- Prompt diagnosis and management are essential for better patient outcomes.