Interpreting the new sore throat article

First, this study required the work of a large team. The main work happened in two places – a research microbiology laboratory and our college health clinic. They took an idea and translated it into an opportunity to collect and analyze data.
Second, the accompanying editorial (written by a friend and excellent researcher Dr. Jeffrey Linder) raises some questions that I will work to answer. He writes that we do not have enough evidence to change practice yet. He postulates that Fusobacterium necrophorum might not actually cause pharyngitis and that linking positive PCR testing to the risk of suppurative complications (peritonsillar abscess or the Lemierre Syndrome) lacks sufficient evidence. In this blog post I will present the evidence for our assertions.
Over the past 2 or 3 decades, some authors started calling Lemierre syndrome “the forgotten disease”. It seems that the syndrome occurred regularly in the first half of the 20th century. After the introduction of penicillin, case reports almost disappeared. With the drive to decrease antibiotic use for sore throats, and the introduction of newer antibiotics that many physicians substituted for penicillin (especially azithromycin) the syndrome seemed to increase in frequency.
Published data suggest that around 80% of the Lemierre syndrome patients have a primary infection with Fusobacterium necrophorum. Danish researchers reported the best two epidemiologic studies of this syndrome. Their studies...

Source: DB's Medical Rants - February 23, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs