Background: Fusobacterium species is rare cause of infections in children. Clinical manifestations vary from mild pharyngitis to Lemierre's syndrome, and even septic shock.
Objective: to characterize clinical manifestations, epidemiologic and prognostic factors of infections with
Fusobacterium species.
Methods: A retrospective analysis of medical records related to microbiologic isolation of
Fusobacterium species in pediatric patients, between the years 2000-2013, in two hospitals of Hadassah-Hebrew University Medical Center.
Results: 21 patients, 11 males and 10 females, mean age 4.18 (SD±3.89) years, 86% of Jewish ethnicity, were identified. 19% had an underlying disease: convulsive disorder, acute lymphocytic leukemia, recurrent UTI and recurrent otitis media.
Fusobacterium necrophorum, nucleatum and species were isolated in 12 (57%), 3 (14%) and 6 (29%) patients, respectively. 15 (71%) had bacteremia. The clinical manifestations included: acute mastoiditis - 8, abscesses (peritonsilar, cervical, subperiosteal, epidural and supraorbital)– 7, Lemeirre's syndrome – 5.
Complications: intracranial infection 9/21 (43%), thrombosis 5/21 (25%), septic shock 2/21 (10 %); metastatic lung infiltration 1/21 (5%). Fourteen (66%) patients required surgical intervention. Excluding one patient who had bacterial sepsis and fusobacterial pericarditis with fatal outcome, all other patients recovered.
Conclusion: Fusobacterial infections are usually severe infections in children, originating from head and neck, associated with high rate of complications, which often require combination approach of surgery and antibiotics. In the vast majority of the patients a favorable outcome is expected.
