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Liu Y, Li Z, Fu H, Ruan W, Wang H, Ding Y, Zhang M. The first case report: diagnosis and management of necrotizing fusobacterium lung abscess via BALF next-generation sequencing. BMC Infect Dis 2024; 24:218. [PMID: 38373919 PMCID: PMC10875748 DOI: 10.1186/s12879-024-09087-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Fusobacterium necrophorum (F. necrophorum)-induced necrotizing pneumonia is a rare but severe pulmonary infection. Insufficient microbiological detection methods can lead to diagnostic difficulties. METHODS We report a case of F. necrophorum lung abscess diagnosed by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF). RESULTS BALF-NGS detected F. necrophorum, guiding subsequent targeted antibiotic therapy. With active drainage and metronidazole treatment, the patient's condition was effectively treated. CONCLUSION BALF-NGS is a valuable tool for the rapid diagnosis of infections caused by difficult-to-culture bacteria. It played a decisive role in the early identification of F. necrophorum, enabling timely and targeted antibiotic intervention. Early diagnosis and appropriate treatment are crucial for the management of F. necrophorum pneumonia.
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Affiliation(s)
- Yang Liu
- Respiratory Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China.
| | - Ziye Li
- Respiratory Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
| | - Handan Fu
- Respiratory Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
| | - Weiliang Ruan
- Respiratory Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
| | - Hua Wang
- Special Inspection Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
| | - Yuhong Ding
- Respiratory Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
| | - Miao Zhang
- Radiology Department, Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine, 312030, Shaoxing, China
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2
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Ibrahim Z, Fox-Lewis S, Correia JA. Fusobacterium necrophorum an Underrecognized Cause of Petrous Apicitis Presenting with Gradenigo Syndrome: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e942652. [PMID: 38319911 PMCID: PMC10862527 DOI: 10.12659/ajcr.942652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/28/2023] [Accepted: 12/19/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND With the advent of antibiotics, petrous apicitis (PA), inflammation of the petrous temporal bone, has become a rare complication of otitis media. Even more uncommon is Gradenigo syndrome (GS), a result of PA, characterized by a triad of otitis media or purulent otorrhea, pain within the regions innervated by the first and second division of the trigeminal nerve, and ipsilateral abducens nerve palsy. Recent literature has demonstrated increasing reports of Fusobacterium necrophorum isolated in cases of GS. CASE REPORT A 21-year-old man presented with otalgia, reduced hearing, and severe headache. Examination revealed right-sided purulent otorrhea, anesthesia within the trigeminal nerve distribution, and an ipsilateral abducens nerve palsy. F. necrophorum was isolated from an ear swab and a blood culture. Computed tomography and magnetic resonance imaging (MRI) demonstrated otomastoiditis, PA, cavernous sinus thrombosis, and severe stenosis of the petrous internal carotid artery. He was treated with intravenous benzylpenicillin, underwent a mastoidectomy and insertion of a ventilation tube, and was started on a 3-month course of dabigatran. Interval MRI showed improved internal carotid artery caliber, persistent petrous apex inflammation, and normal appearance of both cavernous sinuses. Follow-up clinical review noted persistent abducens and trigeminal nerve dysfunction. CONCLUSIONS We identified 190 cases of PA; of these, 80 presented with the classic Gradenigo triad. Fusobacterium sp. were cultured in 10% of GS cases, making them the most frequent isolates. Due to the fastidious nature of F. necrophorum, it may be underrepresented in the historical literature, and we recommend that empiric antibiotics cover anaerobic organisms.
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Affiliation(s)
- Zaid Ibrahim
- Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Shivani Fox-Lewis
- Department of Microbiology, LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - Jason A. Correia
- Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
- Neurosurgery Research Unit, The Centre for Brain Research, The University of Auckland, Auckland, New Zealand
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Khan A, Alzghoul H, Khan AA, Allada G, Gronquist JM, Pak J, Mukundan S, Zakhary B, Wusirika R, Sher N, Reddy R. Epidemiology and Clinical Outcomes of Fusobacterium Infections: A Six-Year Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:248. [PMID: 38399536 PMCID: PMC10890494 DOI: 10.3390/medicina60020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Anaerobic bacteria like Fusobacterium can lead to severe and life-threatening infections. The inherent complexities in the isolation of these bacteria may result in diagnostic and therapeutic delays, thereby escalating both morbidity and mortality rates. We aimed to examine data from patients with infections due to Fusobacterium to gain insights into the epidemiology and clinical outcomes of patients with these infections. Methods and Results: We conducted a retrospective analysis of clinical data from a cohort of patients with cultures positive for Fusobacterium species at a tertiary care medical center in the United States. Between 2009 and 2015, we identified 96 patients with cultures positive for Fusobacterium. Patients could be categorized into three groups based on the site of primary infection. Patients with head and neck infections constituted 37% (n 36). Patients with infections of other soft tissue sites accounted for 38.5% (n 37). Patients with anaerobic bacteremia due to Fusobacterium formed 24% (n 23) of the cohort. Surgical intervention coupled with antibiotic therapy emerged as cornerstones of management for patients with head and neck or other soft tissue infections, who generally exhibited more favorable outcomes. Patients with bacteremia were older, more likely to have malignancy, and had a high mortality rate. When speciation was available, Fusobacterium necrophorum was the most frequently isolated species. Conclusions: Our retrospective analysis of epidemiology and clinical outcomes of Fusobacterium infections revealed three distinct cohorts. Patients with head, neck, or soft tissue infections had better outcomes than those with bacteremia. Our findings highlight the importance of employing management strategies based on infection site and underlying comorbidities in patients with Fusobacterium infections. Further research is needed to investigate the optimal therapeutic strategies and identify prognostic indicators to improve clinical outcomes for these complex infections.
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Affiliation(s)
- Akram Khan
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
| | - Hamza Alzghoul
- Graduate Medical Education, College of Medicine, University of Central Florida, Orlando, FL 32827, USA;
| | - Abdul Ahad Khan
- Division of Pulmonary, Critical Care and Sleep Medicine, Banner University Medical Center, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85721, USA; (A.A.K.)
| | - Gopal Allada
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
| | | | - Jonathan Pak
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
| | - Srini Mukundan
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR 97239-3098, USA;
| | - Bishoy Zakhary
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
| | - Raghav Wusirika
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
| | - Nehan Sher
- Division of Pulmonary, Critical Care and Sleep Medicine, Banner University Medical Center, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85721, USA; (A.A.K.)
| | - Raju Reddy
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA (B.Z.)
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The Role of Extracorporeal Blood Purification in the Treatment of a Patient with Lemierre's Syndrome. Case Rep Med 2022; 2022:8522398. [PMID: 35669315 PMCID: PMC9167122 DOI: 10.1155/2022/8522398] [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: 02/13/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. The condition typically begins with an oropharyngeal infection and frequently involves inflammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue inflammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. The most common etiologic agent is Fusobacterium necrophorum. We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood purification with continuous venous hemodiafiltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins. The use of advanced methods, along with an antibiotic and surgical treatment, will certainly help reduce mortality in this syndrome.
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5
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Bonnesen B, Sivapalan P, Naghavi H, Back Holmgaard D, Sloth C, Wiese L, Kolekar S. A unique case of Fusobacterium nucleatum spondylodiscitis communicating with a pleural empyema through a fistula. APMIS 2021; 129:626-630. [PMID: 34418158 DOI: 10.1111/apm.13171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022]
Abstract
Species (spp.) belonging to the genus Fusobacterium are anaerobic commensals colonizing the upper respiratory tract, the gastrointestinal tract, and the genitals. Infections with Fusobacterium spp. have been reported at many anatomical sites, including pneumonias and pleural empyemas; however, there are very few published cases of Fusobacterium spp. causing spondylodiscitis or fistulas. Bone infections with Fusobacterium can spread directly to surrounding muscular tissue or by hematogenous transmission to any other tissue including pleurae and lungs. Similarly, pleural infections can spread Fusobacterium spp. to any other tissue including fistulas and bone. Concomitant pleural empyema and spondylodiscitis are rare; however, there are a few published cases with concomitant disease, although none caused by Fusobacterium spp. A 77-year-old female patient was assessed using computed tomography (CT) scanning of the thorax and abdomen, as well as analyses of fluid drained from the region affected by the pleural empyema. A diagnosis of Fusobacterium empyema, fistula, bacteremia, and spondylodiscitis was made, and the patient's condition improved significantly after drainage of the pleural empyema and relevant long-term antibiotic treatment. We describe the first confirmed case with concomitant infection with Fusobacterium nucleatum as spondylodiscitis and pleural empyema connected by a fistula.
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Affiliation(s)
- Barbara Bonnesen
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Pradeesh Sivapalan
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Hadi Naghavi
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | | | - Carsten Sloth
- Department of Radiology, Zealand University Hospital, Roskilde, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Shailesh Kolekar
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
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6
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Ahmad F, Farooq A, Khan MUG. Deep Learning Model for Pathogen Classification Using Feature Fusion and Data Augmentation. Curr Bioinform 2021. [DOI: 10.2174/1574893615999200707143535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Bacterial pathogens are deadly for animals and humans. The ease of their dissemination, coupled
with their high capacity for ailment and death in infected individuals, makes them a threat to society.
Objective:
Due to high similarity among genera and species of pathogens, it is sometimes difficult for microbiologists to
differentiate between them. Their automatic classification using deep-learning models can help in reliable, and accurate
outcomes.
Method:
Deep-learning models, namely; AlexNet, GoogleNet, ResNet101, and InceptionV3 are used with numerous
variations including training model from scratch, fine-tuning without pre-trained weights, fine-tuning along with freezing
weights of initial layers, fine-tuning along with adjusting weights of all layers and augmenting the dataset by random
translation and reflection. Moreover, as the dataset is small, fine-tuning and data augmentation strategies are applied to
avoid overfitting and produce a generalized model. A merged feature vector is produced using two best-performing models
and accuracy is calculated by xgboost algorithm on the feature vector by applying cross-validation.
Results:
Fine-tuned models where augmentation is applied produces the best results. Out of these, two-best-performing
deep models i.e. (ResNet101, and InceptionV3) selected for feature fusion, produced a similar validation accuracy of 95.83
with a loss of 0.0213 and 0.1066, and a testing accuracy of 97.92 and 93.75, respectively. The proposed model used xgboost
to attained a classification accuracy of 98.17% by using 35-folds cross-validation.
Conclusion:
The automatic classification using these models can help experts in the correct identification of pathogens.
Consequently, they can help in controlling epidemics and thereby minimizing the socio-economic impact on the community.
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Affiliation(s)
- Fareed Ahmad
- Department of Computer Science and Engineering, Faculty of Electrical Engineering, University of Engineering and Technology, Lahore, Pakistan
| | - Amjad Farooq
- Department of Computer Science and Engineering, Faculty of Electrical Engineering, University of Engineering and Technology, Lahore, Pakistan
| | - Muhammad Usman Ghani Khan
- Department of Computer Science and Engineering, Faculty of Electrical Engineering, University of Engineering and Technology, Lahore, Pakistan
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Scopel Costa B, Filipe da Paz Scardua E, Loss dos Reis W, Nascimento Silva D, Rangel Pereira TC, Vaz SL, Grão Velloso TR. Thoracic pain associated with an odontogenic infection: An unusual Lemierre's syndrome. SPECIAL CARE IN DENTISTRY 2019; 39:441-445. [DOI: 10.1111/scd.12399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/12/2019] [Accepted: 05/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Wyllyam Loss dos Reis
- Intensive care physician of the Cassiano Antônio Moraes University Hospital Vitória Brazil
| | | | | | - Sergio Lins Vaz
- Department of Dental ClinicEspírito Santo Federal University Vitória Brazil
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8
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Differences in mortality in Fusobacterium necrophorum and Fusobacterium nucleatum infections detected by culture and 16S rRNA gene sequencing. Eur J Clin Microbiol Infect Dis 2018; 38:75-80. [PMID: 30374684 DOI: 10.1007/s10096-018-3394-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/27/2018] [Indexed: 12/31/2022]
Abstract
Fusobacterium species are components of the normal microbiota of the oral cavity, gastrointestinal tract, and female genital tract. They are increasingly recognized as causative agents of oral, laryngeal, and tonsillar infections. Several fusobacterial species are involved in infections, with F. necrophorum and F. nucleatum being the most commonly cultured subtypes. In this study, we aimed to investigate clinical and prognostic differences in terms of mortality and association with malignancy between F. necrophorum and F. nucleatum detected by culture and 16S rRNA gene sequencing. This is a systematic, comparative, retrospective, non-interventional study. Data were extracted from the Department of Clinical Microbiology, Region Zealand, Denmark: all patients with F. necrophorum or F. nucleatum detected by culture or 16S rRNA gene sequencing from 1st of January 2010 to 30th of June 2015 were included. In total, F. necrophorum was detected in samples from 75 patients, and F. nucleatum in samples from 68 patients (total: n = 143). Thirteen patients had a current cancer diagnosis at the time of fusobacterial sampling. Multivariate analyses revealed a significant association of "current cancer" with 30-day mortality. Fusobacterial subtype was not associated with mortality neither in overall nor in subgroups with or without current cancer. Despite differences in clinical disease pattern between F. necrophorum and F. nucleatum, mortality was unaffected by fusobacterial subtype. Mortality was significantly related to comorbidity, especially a current diagnosis of cancer. Our data highlights the current debate whether fusobacterial involvement in cancer may have disease-altering properties, rather than being opportunistic pathogens secondary to cancer disease.
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9
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Kitsios GD, Fitch A, Manatakis DV, Rapport SF, Li K, Qin S, Huwe J, Zhang Y, Doi Y, Evankovich J, Bain W, Lee JS, Methé B, Benos PV, Morris A, McVerry BJ. Respiratory Microbiome Profiling for Etiologic Diagnosis of Pneumonia in Mechanically Ventilated Patients. Front Microbiol 2018; 9:1413. [PMID: 30042738 PMCID: PMC6048198 DOI: 10.3389/fmicb.2018.01413] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/08/2018] [Indexed: 01/01/2023] Open
Abstract
Etiologic diagnosis of bacterial pneumonia relies on identification of causative pathogens by cultures, which require extended incubation periods and have limited sensitivity. Next-generation sequencing of microbial DNA directly from patient samples may improve diagnostic accuracy for guiding antibiotic prescriptions. In this study, we hypothesized that enhanced pathogen detection using sequencing can improve upon culture-based diagnosis and that certain sequencing profiles correlate with host response. We prospectively collected endotracheal aspirates and plasma within 72 h of intubation from patients with acute respiratory failure. We performed 16S rRNA gene sequencing to determine pathogen abundance in lung samples and measured plasma biomarkers to assess host responses to detected pathogens. Among 56 patients, 12 patients (21%) had positive respiratory cultures. Sequencing revealed lung communities with low diversity (p < 0.02) dominated by taxa (>50% relative abundance) corresponding to clinically isolated pathogens (concordance p = 0.009). Importantly, sequencing detected dominant pathogens in 20% of the culture-negative patients exposed to broad-spectrum empiric antibiotics. Regardless of culture results, pathogen dominance correlated with increased plasma markers of host injury (receptor of advanced glycation end-products-RAGE) and inflammation (interleukin-6, tumor necrosis factor receptor 1-TNFR1) (p < 0.05), compared to subjects without dominant pathogens in their lung communities. Machine-learning algorithms identified pathogen abundance by sequencing as the most informative predictor of culture positivity. Thus, enhanced detection of pathogenic bacteria by sequencing improves etiologic diagnosis of pneumonia, correlates with host responses, and offers substantial opportunity for individualized therapeutic targeting and antimicrobial stewardship. Clinical translation will require validation with rapid whole meta-genome sequencing approaches to guide real-time antibiotic prescriptions.
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Affiliation(s)
- Georgios D. Kitsios
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
| | - Adam Fitch
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dimitris V. Manatakis
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah F. Rapport
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Kelvin Li
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shulin Qin
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joseph Huwe
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Yingze Zhang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Yohei Doi
- Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - John Evankovich
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - William Bain
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Janet S. Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Barbara Methé
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
| | - Panayiotis V. Benos
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alison Morris
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Bryan J. McVerry
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, United States
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Le Bars P, Matamoros S, Montassier E, Le Vacon F, Potel G, Soueidan A, Jordana F, de La Cochetière MF. The oral cavity microbiota: between health, oral disease, and cancers of the aerodigestive tract. Can J Microbiol 2017; 63:475-492. [PMID: 28257583 DOI: 10.1139/cjm-2016-0603] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many studies show that the human microbiome plays a critical role in the chronic pathologies of obesity, inflammatory bowel diseases, and diabetes. More recently, the interaction between cancer and the microbiome has been highlighted. Most studies have focused on the gut microbiota because it represents the most extensive bacterial community, and the body of evidence correlating it with gut syndromes is increasing. However, in the strict sense, the gastrointestinal (GI) tract begins in the oral cavity, and special attention should be paid to the specific flora of this cavity. This study reviewed the current knowledge about the various microbial ecosystems of the upper part of the GI tract and discussed their potential link to carcinogenesis. The overall composition of the microbial communities, as well as the presence or absence of "key species", in relation to carcinogenesis is addressed. Alterations in the oral microbiota can potentially be used to predict the risk of cancer. Molecular advances and the further monitoring of the microbiota will increase our understanding of the role of the microbiota in carcinogenesis and open new perspectives for future therapeutic and prophylactic modalities.
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Affiliation(s)
- Pierre Le Bars
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Sébastien Matamoros
- b Walloon Excellence in Life Sciences and Biotechnology, Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, 1, place de l'Université, 1348 Brussels, Belgium
| | - Emmanuel Montassier
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Françoise Le Vacon
- d Biofortis Innovation Services - Mérieux NutriSciences, 3, route de la Chatterie, 44800 Saint-Herblain, France
| | - Gilles Potel
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Assem Soueidan
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Fabienne Jordana
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Marie-France de La Cochetière
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
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11
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Johannesen KM, Bodtger U. Lemierre's syndrome: current perspectives on diagnosis and management. Infect Drug Resist 2016; 9:221-227. [PMID: 27695351 PMCID: PMC5028102 DOI: 10.2147/idr.s95050] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This is a systematic review of cases with Lemierre’s syndrome (LS) in the past 5 years. LS is characterized by sepsis often evolving after a sore throat or tonsillitis and then complicated by various septic emboli and thrombosis of the internal jugular vein. Symptoms include sepsis, pain, and/or swelling in the throat or neck, as well as respiratory symptoms. Laboratory findings show elevated infectious parameters and radiological findings show thrombosis of the internal jugular vein and emboli in the lungs or other organs. The syndrome is often associated with an infection with Fusobacterium necrophorum. We found a total of 137 cases of LS, of which 47 were infected with F. necrophorum and others with Staphylococcus and Streptococcus. Complications of this rare but severe disease included osteomyelitis, meningitis, and acute respiratory distress syndrome. Mortality was extremely high in the pre-antibiotic era but has diminished with the advent of antibiotics. This review showed a mortality rate of only 2% of which none of the cases involved fusobacteria. Duration of treatment varied; a 4–6-week course of carbapenem or piperacillin/tazobactam in combination with metronidazole was optimum. Other treatment options included anticoagulants in 46% of cases, which is unwarrantedly high, as to date, no evidence of the positive effects of anticoagulants in LS exists. Only two cases had ligation of the internal jugular vein performed. This review confirms the rare, but severe aspects of LS. Mortality from LS in this day and age appears to be low, however the syndrome is difficult to recognize, and still requires the full attention of the clinician.
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Affiliation(s)
| | - Uffe Bodtger
- Department of Lung Medicine, Naestved Hospital, Naestved; Institute for Regional Health Research, University of Southern Denmark, Odense; Department of Pulmonology, Zealand University Hospital, Roskilde, Denmark
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