Fusobacterium necrophorum

Fusobacterium necrophorum is a species of bacteria responsible for Lemierre's syndrome and other medical problems.

Fusobacterium necrophorum
Scientific classification
Domain: Bacteria
Phylum: Fusobacteria
Class: Fusobacteriia
Order: Fusobacteriales
Family: Fusobacteriaceae
Genus: Fusobacterium
Species:
F. necrophorum
Binomial name
Fusobacterium necrophorum
(Flügge 1886) Moore and Holdeman 1969[1]

Biology

F. necrophorum is a rod-shaped species of Gram-negative bacteria. It is an obligate anaerobe and is a common inhabitant of the alimentary tract within humans and animals.[2]

Pathogenicity

F. necrophorum is responsible for 10% of acute sore throats,[3] 21% of recurrent sore throats[4][5] and 23% of peritonsillar abscesses[6] with the remainder being caused by Group A streptococci or viruses. Other complications from F. necrophorum include meningitis, complicated by thrombosis of the internal jugular vein, thrombosis of the cerebral veins,[7] and infection of the urogenital and the gastrointestinal tracts.[8]

Although this infection is rare, researchers agree that this diagnosis should be considered in a septicaemic patient with thrombosis in an unusual site, and underlying malignancy should be excluded in cases of confirmed F. necrophorum occurring at sites caudal to the head.[9]

The above statistical analysis is dated, necessarily. A 2015 study of young adult students presenting to a single clinic in Alabama had F. necrophorum as the predominate causative organism for pharyngitis 21% of the time (and found in 9% of asymptomatic students).[10] In the same study, Group A Streptococcus was found in 10% of pharyngitis patients (1% of asymptomatic students).

Treatment

F. necrophorum infection (also called F-throat[11]) usually responds to treatment with penicillin or metronidazole, but penicillin treatment for persistent pharyngitis appears anecdotally to have a higher relapse rate, although the reasons are unclear.

Infection in animals

This bacterium has been found to be associated with the foot disease thrush in horses. Thrush is a common infection that occurs on the hoof of a horse, specifically in the region of the frog. F. necrophorum occurs naturally in the animal's environment, especially in wet, muddy, or unsanitary conditions, such as an unclean stall.[12][13] Horses with deep clefts, or narrow or contracted heels are more at-risk to develop thrush.

F. necrophorum is also a cause for lameness in sheep. Its infection is commonly called scald. It can last for several years on land used by either sheep or cattle, and is found on most land of this type throughout the world. Due to its survival length in these areas, it is unrealistic to try to remove it. Sheep most often get scald due to breakage or weakness of the skin surrounding the hoof. This can occur due to strong footbaths, sandy soils, mild frostbite, or prolongened waterlogging of a field, and results in denaturing of the skin between the cleats.[14]

F. necrophorum is the cause of necrotic laryngitis ("calf diphtheria")[15] and liver abscesses [16] in cattle.

See also Blain, an archaic disease of uncertain etiology.
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References
  1. J.P. Euzéby. "Fusobacterium". List of Prokaryotic names with Standing in Nomenclature. Retrieved 9 May 2012.
  2. Tan, Z. L.; Nagaraja, T. G.; Chengappa, M. M. (March 1996). "Fusobacterium necrophorum infections: Virulence factors, pathogenic mechanism and control measures". Veterinary Research Communications. 20 (2): 113–140. doi:10.1007/BF00385634.
  3. Aliyu SH, Marriott RK, Curran MD, et al. (2004). "Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice". J Med Microbiol. 53 (Pt 10): 1029–35. doi:10.1099/jmm.0.45648-0. PMID 15358827.
  4. Batty A, Wren MW (2005). "Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs". Br J Biomed Sci. 62 (2): 66–70. doi:10.1080/09674845.2005.11732687. PMID 15997879.
  5. Batty A, Wren MW, Gal M (2004). "Fusobacterium necrophorum as the cause of recurrent sore throat: comparison of isolates from persistent sore throat syndrome and Lemierre's disease". J Infect. 51 (4): 299–306. doi:10.1016/j.jinf.2004.09.013. PMID 16051369.
  6. Klug TE, Rusan M, Fuursted K, Ovesen T (2009). "Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark". Clin Infect Dis. 49 (10): 1467–1472. doi:10.1086/644616. PMID 19842975.
  7. Larsen PD, Chartrand SA, Adickes M (1997). "Fusobacterium necrophorum meningitis associated with cerebral vessel thrombosis". Pediatr Infect Dis J. 16 (3): 330–331. doi:10.1097/00006454-199703000-00017. PMID 9076827.
  8. Hagelskjaer Kristensen L, Prag J (2000). "Human necrobacillosis, with emphasis on Lemierre's syndrome". Clin Infect Dis. 31 (2): 524–532. doi:10.1086/313970. PMID 10987717.
  9. Redford ML, Ellis R, Rees CJ (2005). "Fusobacterium necrophorum infection associated with portal vein thrombosis". J Med Microbiol. 54 (5): 993–995. doi:10.1099/jmm.0.46080-0. PMID 16157556.
  10. Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, Faircloth MB, Oestreich L, Hatchett J, Khalife W, Waites KB (February 2015). "The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study". Ann. Intern. Med. 162 (4): 241–7. doi:10.7326/M14-1305. PMID 25686164.
  11. "Sore Throat Misdiagnosis Could Kill Teenagers". The People's Pharmacy. 19 February 2015. Retrieved 20 February 2015.
  12. Danvers Child, CJF (7 May 2011). "The Lowdown on Thrush".
  13. Ensminger, M. E. (1990). Horses and Horsemanship: Animal Agriculture Series (Sixth ed.). Danville, IL: Interstate Publishers. p. 62. ISBN 0-8134-2883-1.
  14. "Lameness in Sheep" (PDF). defra Gov.uk. Archived from the original (PDF) on 16 December 2008.
  15. Campbell, John. "Necrotic Laryngitis in Cattle". MSD Manual Veterinary Manual. Merck & Co.
  16. Foreman, Jonathan. "Liver Abscesses in Cattle". MSD Manual Veterinary Manual. Merck & Co.

Further reading

Machado, Vinícius Silva (17 March 2014). "Subcutaneous Immunization with Inactivated Bacterial Components and Purified Protein of Escherichia coli, Fusobacterium necrophorum and Trueperella pyogenes Prevents Puerperal Metritis in Holstein Dairy Cows". PLoS ONE. 9 (3): e91734. doi:10.1371/journal.pone.0091734. PMC 3956715. PMID 24638139.

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