The Fusobacterium story as of 2018 – a very long post

Conclusion:Fusobacterium necrophorum–positive pharyngitis occurs more frequently than group A ?-hemolytic streptococcal–positive pharyngitis in a student population, and F. necrophorum–positive pharyngitis clinically resembles streptococcal pharyngitis. Since Fusobacterium necrophorum recovery increased as the Centor score increased we argued that we had sufficient circumstantial evidence that this organism explained many of the 3s and 4s and that the score really reflected bacterial pharyngitis.  Our subsequent recently published paper on the pharyngitis microbiome strongly supports our contentions. So where are we in 2018.  We have increasing information supporting Fusobacterium necrophorum as an important cause of tonsillitis/pharyngitis in the 15-30 age group.  It does not appear to be very important in pre-adolescents.  We estimate that 1 in 400 Fusobacterium pharyngitis patients will develop the Lemierre Syndrome if they do not receive antibiotics.  Another 2-3% will likely develop peritonsillar abscess (as this age group has the highest incidence of peritonsillar abscess and Fusobacterium necrophorum is now the most common organism found in these abscesses. The Lemierre Syndrome is a devastating infection and while antibiotics successfully treat most patients, these patients often have a horrendous clinical course including significant ICU stays.  In my thinking an ounce of prevention is clearly worth a pound of cure.  So I continue to advocate emp...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs