Lemierre syndrome is caused by an infection in the oropharyngeal region with subsequent thrombophlebitis in the internal jugular vein. The thrombus from the thrombophlebitis can invade other vital organs, such as liver, lungs, or joints, resulting in secondary infection, which further exacerbates the fatal prognosis of this syndrome. Lemierre syndrome, also called postanginal sepsis or necrobacillosis, was first reported by Dr. Lemierre in 1936. In his report, Lemierre mentioned that out of 20 patients who suffered from this syndrome, only two survived. He also stated that all of the 20 patients complained of infections in the palatine tonsils and developed sepsis and thrombophlebitis in the internal jugular vein. Once called a "forgotten disease," this syndrome showed a very high mortality rate until usage of antibiotics became prevalent. In this case report, the authors present a 71-year-old female patient who suffered from Lemierre syndrome with thrombosis extended to the right sigmoid sinus.
Anti-Bacterial Agents ; Coinfection ; Colon, Sigmoid ; Female ; Fusobacterium Infections ; Fusobacterium necrophorum ; Humans ; Joints ; Jugular Veins ; Lemierre Syndrome ; Liver ; Lung ; Palatine Tonsil ; Prognosis ; Sepsis ; Thrombophlebitis ; Thrombosis

Lemierre's syndrome is characterized by anaerobic bacterial infection in the head and neck, causing thrombophlebitis of the jugular vein. This disease is usually associated with a history of pharyngitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Lemierre's syndrome is seen most commonly in teenagers and young adults. We present a case report of a 67-year-old man with an atypical clinical manifestation of an uncommon pathogen in Lemierre's syndrome with epilepsia partialis continua.
Adolescent ; Aged ; Bacterial Infections ; Epilepsia Partialis Continua ; Fusobacterium ; Fusobacterium necrophorum ; Head ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Neck ; Pharyngitis ; Thrombophlebitis ; Venous Thrombosis ; Young Adult

Lemierre syndrome is characterized by anaerobic bacterial infection in the head and neck and clinical or radiological evidence of internal jugular vein thrombophlebitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Septic emboli resulting from infected thrombophlebitis of the internal jugular vein leads to metastatic infections involving lung, liver, kidney, bone and central nervous system. The accurate diagnosis and treatment is important because it may be associated with a high mortality rate if untreated. We present a case of 28-year-old man with an atypical history for the diagnosis of Lemierre syndrome, which showed no definite evidence of internal jugular thrombophlebitis.
Adult ; Bacterial Infections ; Central Nervous System ; Diagnosis ; Empyema ; Fusobacterium ; Fusobacterium necrophorum ; Head ; Humans ; Jugular Veins ; Kidney ; Lemierre Syndrome* ; Liver ; Lung ; Mortality ; Neck ; Thrombophlebitis

Fusobacterium nucleatum (F. nucleatum) is an early pathogenic colonizer in periodontitis, but the host response to infection with this pathogen remains unclear. In this study, we built an F. nucleatum infectious model with human periodontal ligament stem cells (PDLSCs) and showed that F. nucleatum could inhibit proliferation, and facilitate apoptosis, ferroptosis, and inflammatory cytokine production in a dose-dependent manner. The F. nucleatum adhesin FadA acted as a proinflammatory virulence factor and increased the expression of interleukin(IL)-1β, IL-6 and IL-8. Further study showed that FadA could bind with PEBP1 to activate the Raf1-MAPK and IKK-NF-κB signaling pathways. Time-course RNA-sequencing analyses showed the cascade of gene activation process in PDLSCs with increasing durations of F. nucleatum infection. NFκB1 and NFκB2 upregulated after 3 h of F. nucleatum-infection, and the inflammatory-related genes in the NF-κB signaling pathway were serially elevated with time. Using computational drug repositioning analysis, we predicted and validated that two potential drugs (piperlongumine and fisetin) could attenuate the negative effects of F. nucleatum-infection. Collectively, this study unveils the potential pathogenic mechanisms of F. nucleatum and the host inflammatory response at the early stage of F. nucleatum infection.
Humans ; Fusobacterium nucleatum/metabolism* ; NF-kappa B/metabolism* ; Periodontal Ligament/metabolism* ; Signal Transduction ; Fusobacterium Infections/pathology* ; Stem Cells/metabolism*

Humans ; Young Adult ; Fusobacterium necrophorum ; Pharyngitis/microbiology* ; Streptococcal Infections ; Sepsis/diagnosis*

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2x6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.
Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Fusobacterium Infections/complications/*diagnosis/drug therapy ; Fusobacterium nucleatum/*isolation & purification ; Humans ; Injections, Intravenous ; Liver Abscess/*diagnosis/etiology/microbiology ; Male ; Middle Aged ; Periodontal Diseases/*diagnosis ; Sulbactam/therapeutic use

Anaerobic infections have been reported to be responsible for 3–10% of pyogenic liver abscesses in Korea, and reported anaerobes include Fusobacterium, Bacillus fragilis, and Bacteroides melaninogenicus. Parvimonas micra is an anaerobic, Gram-positive, non-spore-forming bacterial species and a constituent of normal flora on skin, vagina, gastrointestinal tract, and oral cavity that can cause opportunistic infections. However, it has only rarely been reported to be a cause of liver abscess; only one such case has been reported in Korea. We experienced a case of concomitant liver and brain abscesses caused by Parvimonas micra in a non-immunodeficient 65-year-old female patient without diabetes or periodontal disease. Parvimonas micra infection was confirmed by blood culture using VITEK® 2 cards and by bacterial 16s ribosomal RNA gene sequencing. We conclude that we should not overlook anaerobes as a cause of liver abscess.
Aged ; Bacillus ; Bacteria, Anaerobic ; Brain Abscess ; Brain ; Female ; Fusobacterium ; Gastrointestinal Tract ; Humans ; Korea ; Liver Abscess ; Liver Abscess, Pyogenic ; Liver ; Mouth ; Opportunistic Infections ; Periodontal Diseases ; Prevotella melaninogenica ; RNA, Ribosomal, 16S ; Skin ; Vagina

OBJECTIVE: To determine the distribution of bacteria in patients with chronic rhinosinusitis, and to compare the bacteriologic features in middle meatus specimens between patients with nasal polyps (CRSwNP) and patients without nasal polyps (CRSsNP). 
 METHODS: We retrospectively analyzed the positive rate and types of bacterial culture in middle meatus specimens from 40 controls, 65 patients with CRSwNP, and 72 patients of CRSsNP. The specimens from the middle meatus were obtained during endoscopic sinus surgery.
 RESULTS: The positive rates of bacteria for CRSwNP, CRSsNP and the controls 81.9%, 80.0% and 82.5%, respectively, with no significant difference among the 3 groups. The common aerobe bacteria found in the specimens was Coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus and Corynebacterium. The common anaerobe was Fusobacterium. The positive rates for aerobic and anaerobic bacteria showed no significant differences among the 3 groups.
 CONCLUSION The distribution of bacteria in middle meatus specimens is not significantly different among CRSwNP, CRSsNP and the controls. Therefore, bacterial infection may not play a key role in the pathogenesis of CRS patients with and without nasal polyos.
Bacterial Infections ; diagnosis ; Case-Control Studies ; Chronic Disease ; Corynebacterium ; isolation & purification ; Endoscopy ; Fusobacterium ; isolation & purification ; Humans ; Nasal Polyps ; microbiology ; Retrospective Studies ; Rhinitis ; microbiology ; Sinusitis ; microbiology ; Staphylococcus aureus ; isolation & purification ; Streptococcus ; isolation & purification

A case of Sturge-Weber Syndrome is presented in a male neonate with severe gangrenous ulcerative stomatitis involving the angiomatous skin lesion and leaving sequele of cleft lip and nasal disfiguration.
Cleft Lip* ; Congenital Abnormalities* ; Gingivitis, Necrotizing Ulcerative ; Humans ; Infant, Newborn ; Male ; Skin ; Sturge-Weber Syndrome*

Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.
Alveolar Bone Loss ; Anti-Bacterial Agents ; Chlorhexidine ; Clinical Protocols ; Dental Scaling ; Diagnosis* ; Gingivitis ; Gingivitis, Necrotizing Ulcerative* ; Humans ; Mouth ; Periodontal Diseases ; Prescriptions