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Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990–1995

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Abstract

To establish the incidence and describe the clinical epidemiology of necrobacillosis and Lemierre's syndrome in Denmark, the clinical records of all laboratory-recorded cases of septicaemia due toFusobacterium necrophorum biovar A, B, and C were reviewed retrospectively during a 6-year period. The incidence of necrobacillosis and Lemierre's syndrome was 1.5 and 0.8 per million persons per year, respectively, showing a tendency to increase during the period.Fusobacterium necrophorum was grown after three days' incubation, but the characteristic pleomorphic fusiform morphology was often disregarded as an important help in diagnosing necrobacillosis. The 24 patients with Lemierre's syndrome were all young and previously healthy, and none died, but pre-hospital delay was associated with a significantly higher morbidity and risk of metastatic infections. The remaining 25 patients with necrobacillosis had a high mortality, 24%, which was correlated with age and predisposing diseases, especially cancers. These findings stress the importance of a quicker clinical and microbiological diagnosis in cases of Lemierre's syndrome, and of screening for cancer in the remaining cases of necrobacillosis.

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References

  1. Lemierre A: On certain septicaemias due to anaerobic organisms. Lancet (1936) i: 701–703

    Google Scholar 

  2. Alston JM: Necrobacillosis in Great Britain. British Medical Journal (1955) II: 1524–1528

    Google Scholar 

  3. Eykyn SJ: Necrobacillosis. Scandinavian Journal of Infectious Diseases (1989) Supplement 62:41–46

    Google Scholar 

  4. Sinave CP, Hardy GJ, Fardy DW: The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (1989) 68:85–94

    Google Scholar 

  5. Moreno S, Altozano JG, Pinilla B, López JC, Quirós B de, Ortega A, Bouza E: Lemierre's disease: postanginal bacteremia and pulmonary involvement caused byFusobacterium necrophorum. Reviews of Infectious Diseases (1989) 11:319–324

    Google Scholar 

  6. Burden P:Fusobacterium necrophorum and Lemierre's syndrome (editorial). Journal of Infection (1991) 23:227–231

    Google Scholar 

  7. Leugers CM, Clover R: Lemierre syndrome: postanginal sepsis. Journal of the American Board of Family Practice (1995) 8:384–391

    Google Scholar 

  8. Koay CB, Heyworth T, Burden P: Lemierre syndrome — a forgotten complication of acute tonsillitis. Journal of Laryngology and Otology (1995) 109:657–661

    Google Scholar 

  9. Carlson ER, Bergamo DF, Coccia CT: Lemierre's syndrome: two cases of a forgotten disease. Journal of Oral Maxillofacial Surgery (1994) 52:74–78

    Google Scholar 

  10. DeSena S, Rosenfeld DL, Santos S, Keller I: Jugular thrombophlebitis complicating bacterial pharyngitis (Lemierre's syndrome). Pediatric Radiology (1996), 26:141–144

    Google Scholar 

  11. Lustig LR, Cusick BC, Cheung SW, Lee KC: Lemierre's syndrome: two cases of postanginal sepsis. Otolaryngology — Head and Neck Surgery (1995) 112:767–772

    Google Scholar 

  12. Moore WEC, Holdeman LV, Kellery RW: Genus II.Fusobacterium. In: Krieg NR. Holl JG (eds): Bergey's manual of systematic bacteriology. Williams & Wilkins, Baltimore (1984) pp. 631–637

    Google Scholar 

  13. Paaske PB, Rasmussen BM, Illum P:Fusobacterium pneumonia and death following uvulo-palato-pharyngoplasty. Head and Neck (1994) 16:450–452

    Google Scholar 

  14. Møller K, Dreijer B: Post-anginal sepsis (Lemierre's disease): a persistent challenge. Presentation of 4 cases. Scandinavian Journal of Infectious Diseases (1997) 29:191–194

    Google Scholar 

  15. Henry S, DeMaria A, McCabe WR: Bacteremia due toFusobacterium species. American Journal of Medicine (1983) 75:225–231

    Google Scholar 

  16. Page Y, Comtet C, Tardy B, Zeni F, Thevenet D, Lucht F, Bertrand J-C: Disseminated intra vascular coagulation withFusobacterium necrophorum septicaemia. Scandinavian Journal of Infectious Diseases (1990) 22:743–747

    Google Scholar 

  17. Baddour LM, Land MA, Barrett FF, Rivara FP, Bruce WE, Bisno AL: Hepatobiliary abnormalities associated with postanginal sepsis. Diagnostic Microbiology and Infectious Disease (1986)4:19–28

    Google Scholar 

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Hagelskjær, L.H., Prag, J., Malczynski, J. et al. Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990–1995. Eur. J. Clin. Microbiol. Infect. Dis. 17, 561–565 (1998). https://doi.org/10.1007/BF01708619

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