Invasive Fusobacterium Infections in children: A Retrospective Multicenter Study

Background: Fusobacterium can cause serious and sometimes life-threatening disease in children. The past few years have witnessed a rise in Fusobacterium infections. This study attempted to describe the epidemiology, clinical and demographic characteristics and the outcomes associated with Fusobacterium infections in hospitalized children in central Israel.

Methods: We retrospectively analyzed the medical records of children Fusobacterium infection (IFI) between January 2010- April 2020. Clinical, laboratory and microbiologic data were retrieved. IFI diagnosis was based on microbiological identification in any specimen by culture or 16S rRNA-PCR.

Results: 51 children with a mean age of 4.49 years were included (26 boys). Hospitalizations for IFI increased from 19 to 50 per 100,000 admissions between 2010-2015 and 2016-2020, respectively, representing a 2.5-fold increase. Most of the infections were from otogenic source (n=28, 55%) followed by oropharyngeal source (n=10, 20%). The most common complications were subperiosteal and epidural abscesses (41% and 37% respectively). Thrombosis was diagnosed in 11 children:10/11 had sinus vein thrombosis (SVT), all had otogenic source. Children with otogenic compared to other infection sources were significantly younger (2.2 vs 7.2 y, p<0.001). 47 children (92%) underwent surgical interventions. All patients survived, one had neurological sequelae.

Conclusions: Admissions because of IFI in children increased during the last 10 years. Otogenic source is the most common source, especially among younger children, and is associated with high rates of complications. Current management including a combination of antibiotics and surgical interventions leads to a favorable outcome.