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[Septicemia due to Fusobacterium necrophorum. A case report]
Abstract:
Septicemia due to the anaerobic gram-negative bacillus Fusobacterium necrophorum is exceptional. It may originate in tonsillitis or intestinal or gynecological infection. We report one case in a young man with head injury. Fusobacterium necrophorum is frequently associated with aerobic pathogens such as streptococcus or staphylococcus (more than fifty per cent of the cases). Metastatic localizations are numerous, often pleuro-pulmonary (infarction, abscess), hepatic (cytolysis) and meningeal (purulent meningitis, cerebral abscess), and in some instances articular (joint swelling) or embolic. Hypercoagulability is often associated. Prognosis is severe (45% mortality rate). Penicillin G seems to be the best antibiotic but erythromycin is effective, as well as imidazole which was very active in our case.
Insights
Septicemia caused by Fusobacterium necrophorum is rare but serious, often linked to other infections and presenting with widespread complications. Early diagnosis and appropriate antibiotic treatment are crucial for improving the poor prognosis.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Septicemia, a life-threatening condition, is rarely caused by the anaerobic gram-negative bacillus Fusobacterium necrophorum.
- Infections typically originate from tonsillitis, intestinal, or gynecological sources.
Observation:
- This report details a rare case of Fusobacterium necrophorum septicemia in a young male patient with a concurrent head injury.
- The bacterium is often found alongside aerobic pathogens like Streptococcus and Staphylococcus, occurring in over 50% of cases.
Findings:
- Metastatic complications are frequent and severe, including pleuro-pulmonary issues (infarction, abscess), hepatic cytolysis, and meningeal involvement (meningitis, cerebral abscess).
- Other potential sites include joints and embolic events, with hypercoagulability frequently observed.
- The overall prognosis is grave, with a reported mortality rate of 45%.
Implications:
- Penicillin G is considered the primary antibiotic of choice.
- Erythromycin and imidazole demonstrate effectiveness, with imidazole showing significant activity in the presented case.
- Prompt recognition and targeted antimicrobial therapy are essential for managing this exceptional and severe infection.