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Saishoji Y, Mori K, Izumi Y. Sternoclavicular Septic Arthritis Caused by Parvimonas micra and Fusobacterium nucleatum Infection with Intra-articular Corticosteroid Administration. Intern Med 2024; 63:341-344. [PMID: 37197959 PMCID: PMC10864072 DOI: 10.2169/internalmedicine.1563-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/26/2023] [Indexed: 05/19/2023] Open
Abstract
Sternoclavicular septic arthritis is a rare form of septic arthritis that can lead to fatal complications, such as abscess formation and mediastinitis, in the absence of prompt diagnosis and appropriate treatment. A man in his 40s presented with pain in the right sternoclavicular joint area, and after a joint injection of steroids was administered, he was diagnosed with septic sternoclavicular arthritis caused by Parvimonas micra and Fusobacterium nucleatum. Gram staining of a specimen obtained from the abscess formation area led to early suspicion of anaerobic infection, and appropriate antibiotics were administered.
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Affiliation(s)
- Yusuke Saishoji
- Department of General Internal Medicine, National Hospital Organization Nagasaki Medical Center, Japan
| | - Keisuke Mori
- Department of Orthopaedic Surgery, National Hospital Organization Nagasaki Medical Center, Japan
| | - Yasumori Izumi
- Department of General Internal Medicine, National Hospital Organization Nagasaki Medical Center, Japan
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Lamtri Laarif M, Schils R, Lifrange F, Valkenborgh C, Pitti P, Brouwers P, Bianchi E, Meex C, Hayette MP. Actinomyces israelii and Fusobacterium nucleatum brain abscess in an immunocompetent patient: case report. Access Microbiol 2023; 5:acmi000499.v4. [PMID: 37424555 PMCID: PMC10323790 DOI: 10.1099/acmi.0.000499.v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/09/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Brain abscess is the most common focal infectious neurological injury. Until the nineteenth century this condition was fatal, however the development of neuroimaging for early diagnosis, neurosurgery and antibiotic therapy in the twentieth century has led to new therapeutic strategies decreasing mortality from 50 % in the 1970s to less than 10 % nowadays. In this context we report a case of brain abscess with a dental origin. Case report A immunocompetent man without any addiction presented to the emergency department with dysarthria and frontal headache at home. The clinical examination was normal. Further investigations revealed a polymicrobial brain abscess as a consequence of an ear, nose or throat (ENT) infection with locoregional extension with a dental starting point involving Actinomyces israelii and Fusobacterium nucleatum . In spite of a rapid diagnosis and a neurosurgical management associated with an optimal treatment by a dual therapy made of ceftriaxone and metronidazole the patient unfortunately died. Conclusion This case report shows that despite a low incidence and a good prognosis following the diagnosis, brain abscesses can lead to patient's death. Thereby, when the patient's condition and urgency allow, a thorough dental examination of patients with neurological signs following the recommendations would improve the diagnosis made by the clinician. The use of microbiological documentation, the respect of pre-analytical conditions, the interaction between the laboratory and the clinicians are indispensable for an optimal management of these pathologies.
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Affiliation(s)
- Mouhsine Lamtri Laarif
- Department of Clinical Biology, Microbiology, University of Liège Hospital, Liège, Belgium
| | - Raphael Schils
- Department of Internal Medicine, Infectious Diseases, University of Liège Hospital, Liège, Belgium
| | - Fréderic Lifrange
- Department of Pathology, University of Liege Hospital, Liège, Belgium
| | | | - Pauline Pitti
- Department of Clinical Biology, Microbiology, University of Liège Hospital, Liège, Belgium
| | - Pauline Brouwers
- Department of Clinical Biology, Microbiology, University of Liège Hospital, Liège, Belgium
| | - Elettra Bianchi
- Department of Pathology, University of Liege Hospital, Liège, Belgium
| | - Cécile Meex
- Department of Clinical Biology, Microbiology, University of Liège Hospital, Liège, Belgium
| | - Marie-Pierre Hayette
- Department of Clinical Biology, Microbiology, University of Liège Hospital, Liège, Belgium
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Srour N, Demand A, Zhang Y, Musick W, Lista A, Lin J. Ruptured intraventricular brain abscesses due to Fusobacterium nucleatum with obstructive hydrocephalus: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 5:CASE22195. [PMID: 36647249 PMCID: PMC9844524 DOI: 10.3171/case22195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fusobacterium spp. are strictly anaerobic microorganisms and normal flora of the oropharyngeal, gastrointestinal, and female genital tracts. It is commonly associated with periodontal disease, pharyngitis, mastoiditis, and tonsillitis, with a tendency to abscess formation. OBSERVATIONS The authors report a case of brain abscesses complicated by ventriculitis and obstructive hydrocephalus caused by Fusobacterium nucleatum of suspected odontogenic source. While repeated bacterial cultures remained negative, the isolate was identified using bacterial sequencing. LESSONS Empirical antimicrobial coverage for F. nucleatum should be considered in patients presenting with brain abscess. Genetic bacterial sequencing utilizing 16S ribosomal RNA molecular diagnostic testing may assist in microorganism identification to guide antimicrobial therapy.
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Affiliation(s)
| | | | - Yi Zhang
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas
| | | | | | - Jeijan Lin
- Infectious Diseases, Houston Methodist Hospital, Houston, Texas; and
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[NLRC4 plays a regulatory role in F. nucleatum-induced pyroptosis in macrophages]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2022; 42:1560-1565. [PMID: 36329592 PMCID: PMC9637494 DOI: 10.12122/j.issn.1673-4254.2022.10.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To explore the mechanism of F.nucleatum-induced pyroptosis in macrophages and the regulatory role of inflammasomes. METHODS Lactate dehydrogenase (LDH) cytotoxicity assay and Hoechst 33342/PI double fluorescence staining were used to analyze cytolysis in F.nucleatum-infected macrophage RAW264.7 cells.The expressions of pyroptosis-related proteins caspase-1, GSDMD and IL-1β were determined using Western blotting.Inflammasome activation in the cells was analyzed by detecting the mRNA expressions of NLRP3, NLRC4, AIM2, and NLRP1 with qRT-PCR.RNA interference technique was used to knock down the key molecules involved in pyroptosis regulation in the macrophages, and the pyroptosis and necrosis rates of the cells following F.nucleatum infection were examined. RESULTS The results of LDH cytotoxicity assay and double-fluorescence staining showed that F.nucleatum infection caused swelling and lytic cell death in RAW264.7 cells.F.nucleatum infection resulted in the activation of caspase-1 and GSDMD and upregulated IL-1β expression in a multiplicity of infection (MOI)-and time-dependent manner (P < 0.05).qRT-PCR revealed significantly increased expression of NLRC4 mRNA in the macrophages after F.nucleatum infection (P < 0.05).NLRC4 silencing by siRNA strongly inhibited the activation of caspase-1/GSDMD pathway and reduced cell death (P < 0.05) and IL-1β expression in F.nucleatum-infected cells. CONCLUSION NLRC4 inflammasome drives caspase-1/GSDMD-mediated pyroptosis and inflammatory signaling in F.nucleatum-infected macrophages, suggesting the potential of NLRC4 inflammasome as a therapeutic target for F.nucleatum infections.
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Cheng H, Xu L, Yang F, Jia L, Zhao D, Li H, Liu W, Li Y, Liu X, Geng X, Guo J, Ling C, Zhang J. Case report: Meningitis and intracranial aneurysm caused by mixed infection of oral microflora dominated by anaerobes. Front Neurol 2022; 13:889838. [PMID: 35989934 PMCID: PMC9389152 DOI: 10.3389/fneur.2022.889838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Meningitis caused by oral anaerobic bacteria is rare, especially when complicated with an infected intracranial aneurysm. This paper has described an extremely rare case of bacterial meningitis caused by a mixed infection of oral microflora dominated by anaerobes, which developed cerebral infarcts, brain abscess, intracranial aneurysm, and severe hydrocephalus during treatment. Case report We describe a 65-year-old male patient who was presented with fever and headache as the initial symptoms and then developed left ophthalmoplegia, right hemiplegia, and disturbance of consciousness. Brain imaging showed that intracranial lesions were increased progressively, and cerebral infarcts, brain abscesses, intracranial aneurysm, and severe hydrocephalus were appeared gradually. Eventually, we diagnosed it as anaerobic meningitis by making deoxyribonucleic acid sequencing from the brain abscess pus. After using an anti-microbial regimen that can sufficiently cover anaerobes, the patient's condition was effectively controlled. Conclusion Anaerobic meningitis can cause a series of intracranial complications. Among them, the intracranial aneurysm is extremely rare. When evidence shows that the infection originates from oral flora, physicians should consider the possibility of this type of encephalitis. An early diagnosis and timely treatment are crucial to improving the prognosis.
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Affiliation(s)
- Hongjiang Cheng
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Lina Xu
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
- *Correspondence: Lina Xu
| | - Fengbing Yang
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Longbin Jia
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
- Longbin Jia
| | - Doudou Zhao
- Department of Rheumatology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
- Doudou Zhao
| | - Huimin Li
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Wei Liu
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Yujuan Li
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Xiaoli Liu
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Xia Geng
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Jiaying Guo
- Department of Neurology, Jincheng People's Hospital Affiliated to Shanxi Medical University, Jincheng, China
| | - Chen Ling
- Graduate School of Changzhi Medical College, Changzhi, China
| | - Jing Zhang
- Graduate School of Changzhi Medical College, Changzhi, China
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Cao P, Chen Q, Shi C, Wang L, Gong Z. Fusobacterium nucleatum promotes the development of acute liver failure by inhibiting the NAD + salvage metabolic pathway. Gut Pathog 2022; 14:29. [PMID: 35765030 PMCID: PMC9238040 DOI: 10.1186/s13099-022-00503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute liver failure (ALF) patients are often accompanied by severe energy metabolism abnormalities and intestinal microecological imbalance. The intestinal mucosal barrier is severely damaged. Intestinal endotoxin can induce intestinal endotoxemia through the "Gut-Liver axis". More and more evidence shows that members of the gut microbiota, especially Fusobacterium nucleatum (F. nucleatum), are related to inflammatory bowel disease, but whether F. nucleatum is involved in the development of ALF and whether it affects the liver energy metabolism is unclear. METHODS This study first detected the abundance of F. nucleatum and its effect on ALF disease, and explored whether F. nucleatum aggravated liver inflammation in vitro and in vivo. RESULTS Our data showed that liver tissues of ALF patients contained different abundances of F. nucleatum, which were related to the degree of liver inflammation. In addition, we found that F. nucleatum infection affected the energy metabolism of the liver during the development of ALF, inhibited the synthesis pathway of nicotinamide adenine dinucleotide (NAD+)'s salvage metabolism, and promoted inflammatory damage in the liver. In terms of mechanism, F. nucleatum inhibited NAD+ and the NAD+-dependent SIRT1/AMPK signaling pathway, and promoted liver damage of ALF. CONCLUSIONS Fusobacterium nucleatum coordinates a molecular network including NAD+ and SIRT1 to control the progress of ALF. Detection and targeting of F. nucleatum and its related pathways may provide valuable insights for the treatment of ALF.
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Affiliation(s)
- Pan Cao
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, 238 Jie Fang Road, Wuhan, 430060, People's Republic of China
| | - Qian Chen
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, 238 Jie Fang Road, Wuhan, 430060, People's Republic of China
| | - Chunxia Shi
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, 238 Jie Fang Road, Wuhan, 430060, People's Republic of China
| | - Luwen Wang
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, 238 Jie Fang Road, Wuhan, 430060, People's Republic of China
| | - Zuojiong Gong
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, 238 Jie Fang Road, Wuhan, 430060, People's Republic of China.
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Lee SJ, Baek YJ, Kim JN, Lee KH, Lee EH, Yeom JS, Choi JY, Ku NS, Ahn JY, Kim JH, Jeong SJ. Increasing Fusobacterium infections with Fusobacterium varium, an emerging pathogen. PLoS One 2022; 17:e0266610. [PMID: 35421136 PMCID: PMC9009667 DOI: 10.1371/journal.pone.0266610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/23/2022] [Indexed: 11/18/2022] Open
Abstract
Infections caused by Fusobacterium species are rare; however serious infections with complications or mortality may occur occasionally. We conducted a retrospective study to investigate the clinical features of patients with Fusobacterium infections and the differences between infections caused by the species F. necrophorum, F. nucleatum, and F. varium. Additionally, we attempted to identify risk factors for Fusobacterium-associated mortality. This study included all patients at a large tertiary care teaching hospital in South Korea with Fusobacterium infections from January 2006 to April 2021. Demographic, clinical, laboratory, and outcome data were analyzed. Multiple logistic regression analysis was performed to assess the risk factors for in-hospital mortality associated with F. nucleatum and F. varium infections. We identified 272 patients with Fusobacterium infections during the study period. The number of Fusobacterium cases has increased recently, with F. varium infections markedly increasing since 2016 and causing a significant proportion of infections. Patients with F. varium infections were older and had a higher proportion of nosocomial infections than the other groups. The F. nucleatum and F. varium groups showed higher in-hospital mortality than the F. necrophorum group. Through logistic regression analysis, APACHE II score and serum albumin level were considered risk factors for in-hospital mortality. APACHE II score was positively correlated with age, red cell distribution width, and serum blood urea nitrogen, and negatively correlated with serum albumin level. Infections caused by Fusobacterium species are increasing. F. varium causes a significant proportion of severe infections.
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Affiliation(s)
- Se Ju Lee
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Yae Jee Baek
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Jin Nam Kim
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Ki Hyun Lee
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Eun Hwa Lee
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Joon Sup Yeom
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Nam Su Ku
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Jin Young Ahn
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Jung Ho Kim
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
| | - Su Jin Jeong
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, South Korea
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Educational case: Brain abscess. Acad Pathol 2022; 9:100017. [PMID: 35770199 PMCID: PMC9234233 DOI: 10.1016/j.acpath.2022.100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/28/2021] [Accepted: 01/02/2022] [Indexed: 12/02/2022] Open
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9
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Kunadia A, Leong MB, Komanduri K, Abdelmasih R, Tarasiuk-Rusek A. Emphysematous Cholecystitis Secondary to Fusobacterium nucleatum. Cureus 2021; 13:e15660. [PMID: 34277253 PMCID: PMC8281795 DOI: 10.7759/cureus.15660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 12/07/2022] Open
Abstract
Fusobacterium nucleatum may be implicated in cases of emphysematous cholecystitis (EC) and carries a high mortality risk, especially in individuals with heart disease, renal insufficiency, and underlying malignancy. Fusobacterium infections are rarely detected in the setting of cholecystitis possibly due to the difficulty with properly culturing the bacteria. We describe a case of a patient with EC in whom blood cultures were positive for growth of F. nucleatum in one of two samples. The patient was treated with empiric antibiotic therapy consisting of metronidazole and cefepime. In patients with EC and negative cultures, it is possible that they may have an undetected infection with fusobacteria, which carries a high mortality risk. As such, clinicians should maintain a high degree of suspicion of obligate anaerobic infection in patients who have negative blood culture for growth in the setting of EC and consider continuation of adequate antimicrobial coverage.
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Affiliation(s)
- Anuj Kunadia
- Internal Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Michael B Leong
- Internal Medicine, University of Central Florida, Orlando, USA
| | - Karthikram Komanduri
- Internal Medicine, Ocala Regional Medical Center, University of Central Florida College of Medicine, Ocala, USA.,Internal Medicine, Ocala Regional Medical Center, University of Central Florida, Ocala, USA
| | - Randa Abdelmasih
- Internal Medicine, Ocala Regional Medical Center, University of Central Florida College of Medicine, Ocala, USA
| | - Aneta Tarasiuk-Rusek
- Infectious Disease, Ocala Regional Medical Center, University of Central Florida College of Medicine, Ocala, USA
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Chaovarin C, Polpong P, Sungkhachat O. Fusobacterium nucleatum and brain abscess: Case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.101062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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11
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Rubel IF, Reino FM. Full Femoral Osteomyelitis Caused by Fusobacterium nucleatum in an Immunocompetent Adult: A Case Report. JBJS Case Connect 2020; 10:e20.00320. [PMID: 33449545 DOI: 10.2106/jbjs.cc.20.00320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CASE We present a 46-year-old man who developed a full femoral osteomyelitis caused by Fusobacterium nucleatum. The subtle presentation of the infection and the late onset of appropriate antibiotic treatment caused a devastating bone quality of the full femur. CONCLUSIONS A successful outcome was obtained with surgical debridement, antibiotics, and return to weight bearing guided by a laboratory and radiographic scale specially designed to avoid pathologic fractures toward his full functional recovery.
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Affiliation(s)
- Ivan F Rubel
- Orthopaedics Department, Fleni Institute, Buenos Aires, Argentina
- Internal Medicine Department, Fleni Institute, Buenos Aires, Argentina
| | - Fabricio M Reino
- Internal Medicine Department, Fleni Institute, Buenos Aires, Argentina
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12
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Glycan cross-feeding supports mutualism between Fusobacterium and the vaginal microbiota. PLoS Biol 2020; 18:e3000788. [PMID: 32841232 PMCID: PMC7447053 DOI: 10.1371/journal.pbio.3000788] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022] Open
Abstract
Women with bacterial vaginosis (BV), an imbalance of the vaginal microbiome, are more likely to be colonized by potential pathogens such as Fusobacterium nucleatum, a bacterium linked with intrauterine infection and preterm birth. However, the conditions and mechanisms supporting pathogen colonization during vaginal dysbiosis remain obscure. We demonstrate that sialidase activity, a diagnostic feature of BV, promoted F. nucleatum foraging and growth on mammalian sialoglycans, a nutrient resource that was otherwise inaccessible because of the lack of endogenous F. nucleatum sialidase. In mice with sialidase-producing vaginal microbiotas, mutant F. nucleatum unable to consume sialic acids was impaired in vaginal colonization. These experiments in mice also led to the discovery that F. nucleatum may also “give back” to the community by reinforcing sialidase activity, a biochemical feature of human dysbiosis. Using human vaginal bacterial communities, we show that F. nucleatum supported robust outgrowth of Gardnerella vaginalis, a major sialidase producer and one of the most abundant organisms in BV. These results illustrate that mutually beneficial relationships between vaginal bacteria support pathogen colonization and may help maintain features of dysbiosis. These findings challenge the simplistic dogma that the mere absence of “healthy” lactobacilli is the sole mechanism that creates a permissive environment for pathogens during vaginal dysbiosis. Given the ubiquity of F. nucleatum in the human mouth, these studies also suggest a possible mechanism underlying links between vaginal dysbiosis and oral sex. Bacterial mutualism involving the prominent oral bacterium Fusobacterium nucleatum may drive vaginal dysbiosis in women and could help to explain the clinical correlations between vaginal dysbiosis and oral sex.
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An immunocompetent patient with culture-negative multiple brain abscesses caused by Fusobacterium nucleatum. Anaerobe 2020; 65:102261. [PMID: 32841677 DOI: 10.1016/j.anaerobe.2020.102261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/05/2020] [Accepted: 08/15/2020] [Indexed: 11/24/2022]
Abstract
The diagnosis and treatment of brain abscesses have advanced due to the utilization of modern microbiological and neurosurgical methods. Here we present a 49-year-old female patient presented with headache and neurological symptoms. Initial evaluation revealed multiple ring-enhanced brain lesions and a lung cavitary lesion initially suspected to represent a malignant process. Stereotactic aspiration provided the diagnosis of brain abscesses but yielded negative cultures. 16S ribosomal RNA analysis enabled the identification of Fusobacterium nucleatum. For ten weeks, the patient was treated with ceftriaxone and metronidazole. A marked clinical and radiological improvement was noted. Brain abscess is a severe intracranial infectious process with significant morbidity and mortality. Microbiological analysis is challenging due to the location of the infection, the broad spectrum of causative agents, and the low yield of cultures. Fusobacterium nucleatum is an anaerobic bacteria with a tendency to abscess formation and is isolated from 2% of brain abscesses. The utilization of 16S RNA analysis improves microbiological identification rates in brain abscesses, as in other infectious entities, enabling better pathogen characterization and more suitable treatment.
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Chronic Inflammation as a Link between Periodontitis and Carcinogenesis. Mediators Inflamm 2019; 2019:1029857. [PMID: 31049022 PMCID: PMC6458883 DOI: 10.1155/2019/1029857] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/03/2019] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is characterized by a chronic inflammation produced in response to a disease-associated multispecies bacterial community in the subgingival region. Although the inflammatory processes occur locally in the oral cavity, several studies have determined that inflammatory mediators produced during periodontitis, as well as subgingival species and bacterial components, can disseminate from the oral cavity, contributing therefore, to various extraoral diseases like cancer. Interestingly, carcinogenesis associated with periodontal species has been observed in both the oral cavity and in extra oral sites. In this review, several studies were summarized showing a strong association between orodigestive cancers and poor oral health, presence of periodontitis-associated bacteria, tooth loss, and clinical signs of periodontitis. Proinflammatory pathways were also summarized. Such pathways are activated either by mono- or polymicrobial infections, resulting in an increase in the expression of proinflammatory molecules such as IL-6, IL-8, IL-1β, and TNF-α. In addition, it has been shown that several periodontitis-associated species induce the expression of genes related to cell proliferation, cell cycle, apoptosis, transport, and immune and inflammatory responses. Intriguingly, many of these pathways are linked to carcinogenesis. Among them, the activation of Toll-like receptors (TLRs) and antiapoptotic pathways (such as the PI3K/Akt, JAK/STAT, and MAPK pathways), the reduction of proapoptotic protein expression, the increase in cell migration and invasion, and the enhancement in metastasis are addressed. Considering that periodontitis is a polymicrobial disease, it is likely that mixed species promote carcinogenesis both in the oral cavity and in extra oral tissues and probably—as observed in periodontitis—synergistic and/or antagonistic interactions occur between microbes in the community. To date, a good amount of studies has allowed us to understand how monospecies infections activate pathways involved in tumorigenesis; however, more studies are needed to determine the combined effect of oral species in carcinogenesis.
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Dahmus JD, Kotler DL, Kastenberg DM, Kistler CA. The gut microbiome and colorectal cancer: a review of bacterial pathogenesis. J Gastrointest Oncol 2018; 9:769-777. [PMID: 30151274 DOI: 10.21037/jgo.2018.04.07] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common newly diagnosed cancer in both men and women in the Unites States. Colonoscopy has become increasingly popular in CRC screening and represents the gold standard for detecting and removing pre-cancerous lesions. Although colonoscopy is considered a relatively safe procedure, it is invasive and bowel preparation can be challenging for patients. As interest in the gut microbiome has expanded, there have been new links established between bacteria and the development of CRC. These developing associations could prove to be a useful adjunct to colonoscopy for CRC screening in the future. This review examines current research evaluating multiple proposed pathogenic microorganisms including sulfidogenic bacteria such as Bilophila wadsworthia, as well as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, and Clostridium septicum. This discussion primarily focuses on bacterial pathogenesis, evidence of association with CRC, and the proposed mechanisms of carcinogenesis.
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Affiliation(s)
- Jessica D Dahmus
- Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Drew L Kotler
- Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - David M Kastenberg
- Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - C Andrew Kistler
- Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
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Chao GF, Hirji S, Shikora SA. Extensive Thrombus and Brain Microabscesses After Sleeve Gastrectomy. J Radiol Case Rep 2018; 12:10-17. [PMID: 29875989 DOI: 10.3941/jrcr.v12i3.3227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Sleeve gastrectomy is a relatively newer bariatric surgical procedure and has become the most common of all bariatric surgeries performed. Complication rates reported with sleeve gastrectomies are relatively low and are generally due to staple line leaks, hemorrhage, or sleeve stricture. Portal vein thrombosis is an uncommon but potentially dangerous complication. We present a case of a 21-year-old woman who developed thrombosis of the portal, splenic, and right common iliac veins that then resulted in multifocal brain abscesses from presumed Fusobacterium septic emboli following an uncomplicated laparoscopic sleeve gastrectomy.
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Affiliation(s)
| | - Sameer Hirji
- Department of Surgery, Brigham and Women's Hospital, Boston, USA
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17
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Anaerobic bacterial meningitis in adults. J Clin Neurosci 2018; 50:45-50. [DOI: 10.1016/j.jocn.2018.01.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/05/2018] [Indexed: 11/19/2022]
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18
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Hibi A, Amakusa Y. Intracranial subdural abscess with polymicrobial infections due to frontal sinusitis in an adolescent: life-threatening complication of a common disease. Clin Case Rep 2018; 6:516-521. [PMID: 29531731 PMCID: PMC5838286 DOI: 10.1002/ccr3.1355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/17/2017] [Accepted: 12/10/2017] [Indexed: 01/28/2023] Open
Abstract
Intracranial abscess is one of the most serious complications of frontal sinusitis, particularly among adolescents, even in the absence of odontogenic infection. Polymicrobial infections due to anaerobes are common. Because antibiotic therapy alone is usually ineffective, early endoscopic sinus surgery is the key for infection control and good clinical outcomes.
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Affiliation(s)
- Arata Hibi
- Division of Nephrology and RheumatologyDepartment of Internal MedicineKariya Toyota General Hospital5‐15, Sumiyoshi‐choKariyaAichi448‐8505Japan
| | - Yoshinobu Amakusa
- Department of NeurologyKariya Toyota General Hospital5‐15, Sumiyoshi‐choKariyaAichi448‐8505Japan
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19
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Houston H, Kumar K, Sajid S. Asymptomatic pyogenic liver abscesses secondary to Fusobacterium nucleatum and Streptococcus vestibularis in an immunocompetent patient. BMJ Case Rep 2017; 2017:bcr-2017-221476. [PMID: 28942408 DOI: 10.1136/bcr-2017-221476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A 66-year-old male patient presented with symptoms and signs of L4/5 radiculopathy. He was found to be anaemic with elevated inflammatory markers and deranged hepatic enzymes. Imaging revealed lumbar canal stenosis and the presence of pyogenic liver abscesses from which Fusobacterium nucleatum and Streptococcus vestibularis were isolated. The hepatic abscesses were attributed to asymptomatic diverticular perforation. Multiple coexisting incidental infections were discovered, including oesophageal candidiasis, Helicobacter pylori, stool cultures positive for Strongyloides stercoralis, and sputum cultures positive for Enterobacter cloacae, Escherichia coli and Mycobacterium avium Extensive investigations for possible underlying immunosuppression were negative.
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Affiliation(s)
- Hamish Houston
- North Middlesex University Hospital NHS Trust, London, UK
| | - Kartik Kumar
- North Middlesex University Hospital NHS Trust, London, UK
| | - Salman Sajid
- North Middlesex University Hospital NHS Trust, London, UK
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20
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Mourad MR, Siwoski OM, Brownback KR. A 19-Year-Old College Student With Headache, Photophobia, and Flulike Illness. Chest 2017; 151:e95-e98. [PMID: 28390644 DOI: 10.1016/j.chest.2016.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/05/2016] [Accepted: 10/20/2016] [Indexed: 10/19/2022] Open
Abstract
CASE PRESENTATION A 19-year-old previously healthy man presented, minimally responsive, in respiratory distress to an ED after a 2-week history of headache, photophobia, and neck stiffness. Associated symptoms included low-grade fevers, malaise, and dark urine. He had no recent travel, ill contacts, consumption of undercooked meat, new sexual contacts, or illicit drug use. The patient resided in a campus dormitory and did not consume alcohol or tobacco.
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Affiliation(s)
- Mohamed Ramez Mourad
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Olivia M Siwoski
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Kyle R Brownback
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS.
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21
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Detection of Fusobacterium nucleatum in culture-negative brain abscess by broad-spectrum bacterial 16S rRNA Gene PCR. IDCases 2017; 8:94-95. [PMID: 28516038 PMCID: PMC5430554 DOI: 10.1016/j.idcr.2017.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 12/03/2022] Open
Abstract
Background Fusobacterium nucleatum is a strict anaerobic microorganism commensal to the human oropharynx and gastrointestinal tract, which causes a wide spectrum of human diseases and it is an important pathogen in abscesses. Case presentation We report the case of a previously healthy 64-year-old woman with multiple abscesses due to Fusobacterium nucleatum, involving liver, pleura and brain. Fusobacterium was not recovered from blood cultures nor from culture of hepatic, pleural and brain drain fluid. The diagnosis was obtained by polymerase chain reaction amplification of bacterial deoxyribonucleic acid in brain abscess drain. Conclusions Fusobacterium spp., should be considered in patients with any organ abscess, especially in case of invasive disease with multiple secondary site involving brain. Molecular techniques might be of special usefulness in cases that remain negative in culture to obtain the diagnosis and perform adequate treatment.
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Lewis AL, Robinson LS, Agarwal K, Lewis WG. Discovery and characterization of de novo sialic acid biosynthesis in the phylum Fusobacterium. Glycobiology 2016; 26:1107-1119. [PMID: 27613803 DOI: 10.1093/glycob/cww068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 12/15/2022] Open
Abstract
Sialic acids are nine-carbon backbone carbohydrates found in prominent outermost positions of glycosylated molecules in mammals. Mimicry of sialic acid (N-acetylneuraminic acid, Neu5Ac) enables some pathogenic bacteria to evade host defenses. Fusobacterium nucleatum is a ubiquitous oral bacterium also linked with invasive infections throughout the body. We employed multidisciplinary approaches to test predictions that F. nucleatum engages in de novo synthesis of sialic acids. Here we show that F. nucleatum sbsp. polymorphum ATCC10953 NeuB (putative Neu5Ac synthase) restores Neu5Ac synthesis to an Escherichia coli neuB mutant. Moreover, purified F. nucleatum NeuB participated in synthesis of Neu5Ac from N-acetylmannosamine and phosphoenolpyruvate in vitro Further studies support the interpretation that F. nucleatum ATCC10953 NeuA encodes a functional CMP-sialic acid synthetase and suggest that it may also contain a C-terminal sialic acid O-acetylesterase. We also performed BLAST queries of F. nucleatum genomes, revealing that only 4/31 strains encode a complete pathway for de novo Neu5Ac synthesis. Biochemical studies including mass spectrometry were consistent with the bioinformatic predictions, showing that F. nucleatum ATCC10953 synthesizes high levels of Neu5Ac, whereas ATCC23726 and ATCC25586 do not express detectable levels above background. While there are a number of examples of sialic acid mimicry in other phyla, these experiments provide the first biochemical and genetic evidence that a member of the phylum Fusobacterium can engage in de novo Neu5Ac synthesis.
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Affiliation(s)
- Amanda L Lewis
- Department of Molecular Microbiology .,Department of Obstetrics and Gynecology
| | | | | | - Warren G Lewis
- Department of Medicine, Center for Women's Infectious Disease Research, 660 South Euclid Ave, Washington University School of Medicine, St. Louis, MO, USA
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