Analysis of the tonsillar microbiome in young adults with sore throat reveals a high relative abundance of Fusobacterium necrophorum with low diversity

PurposeThe main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC).MethodsIn this systematic review and meta-analysis, we searched Scopus and PubMed for case–control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A Streptococcus (GAS).ResultsPubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%).ConclusionsThe results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS.

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Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04180-y ◽

2021 ◽

Author(s):

Tejs Ehlers Klug ◽

Thomas Greve ◽

Camilla Andersen ◽

Pernille Hahn ◽

Christian Danstrup ◽

...

Keyword(s):

Streptococcus Pyogenes ◽

Relative Abundance ◽

Maximum Growth ◽

Fusobacterium Necrophorum ◽

Adult Patients ◽

Tonsillar Tissue ◽

Streptococcus Anginosus ◽

Parapharyngeal Abscess ◽

Bacterial Cultures

AbstractWe aimed to describe the microbiology of parapharyngeal abscess (PPA) and point out the likely pathogens using the following principles to suggest pathogenic significance: (1) frequent recovery, (2) abundant growth, (3) growth in relative abundance to other microorganisms, (4) percentage of the isolates recovered in both absolute and relative abundance, (5) more frequent recovery in PPA pus compared with tonsillar surface and tissue. Comprehensive bacterial cultures were performed on specimens obtained from adult patients (n = 60) with surgically verified PPA, who were prospectively enrolled at five Danish ear-nose-throat departments. The prevalent isolates (in PPA pus) were unspecified anaerobes (73%), non-hemolytic streptococci (67%), Streptococcus anginosus group (SAG) (40%), Corynebacterium spp. (25%), Neisseria spp. (23%), Fusobacterium spp. (22%), Fusobacterium necrophorum (17%), Prevotella spp. (12%), and Streptococcus pyogenes (10%). The bacteria most frequently isolated in heavy (maximum) growth were unspecified anaerobes (60%), SAG (40%), F. necrophorum (23%), and Prevotella spp. (17%). The predominant microorganisms (those found in highest relative abundance) were unspecified anaerobes (53%), SAG (28%), non-hemolytic streptococci (25%), F. necrophorum (15%), S. pyogenes (10%), and Prevotella spp. (10%). Four potential pathogens were found in both heavy growth and highest relative abundance in at least 50% of cases: F. necrophorum, Prevotella spp., SAG, and S. pyogenes. SAG, Prevotella spp., F. necrophorum, S. pyogenes, and Bacteroides spp. were recovered with the same or higher frequency from PPA pus compared with tonsillar tissue and surface. Our findings suggest that SAG, F. necrophorum, Prevotella, and S. pyogenes are significant pathogens in PPA development.

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Fusobacterium necrophorum as the cause of recurrent sore throat: comparison of isolates from persistent sore throat syndrome and Lemierre's disease

Journal of Infection ◽

10.1016/j.jinf.2004.09.013 ◽

2005 ◽

Vol 51 (4) ◽

pp. 299-306 ◽

Cited By ~ 49

Author(s):

Antonia Batty ◽

M.W.D. Wren ◽

Michaela Gal

Keyword(s):

Sore Throat ◽

Fusobacterium Necrophorum ◽

Lemierre’S Disease

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Prevalence of Group C Streptococcus and Fusobacterium Necrophorum in Patients With Sore Throat: A Meta-Analysis

The Annals of Family Medicine ◽

10.1370/afm.2005 ◽

2016 ◽

Vol 14 (6) ◽

pp. 567-574 ◽

Cited By ~ 7

Author(s):

C. Marchello ◽

M. H. Ebell

Keyword(s):

Sore Throat ◽

Meta Analysis ◽

Fusobacterium Necrophorum

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Lymphangiomatous Polyp of the Tonsil: An Unusual Cause of Snoring

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1198 ◽

2015 ◽

Vol 7 (2) ◽

pp. 88-90

Author(s):

Shubha P Bhat ◽

Shrinath D Kamath Patla ◽

Natasha Hilda Rent ◽

Kishore Chandra Shetty

Keyword(s):

Young Adults ◽

Sore Throat ◽

Adult Male ◽

Histopathological Examination ◽

Final Diagnosis ◽

Curative Treatment ◽

Vascular Tumors ◽

Palatine Tonsils ◽

Children And Young Adults ◽

Left Tonsil

ABSTRACT Benign vascular tumors and hamartomatous malformations of the palatine tonsils are less common than malignancies and are infrequently encountered. Lymphangiomatous polyp (LAP) is a rare hamartomatous lesion, arising from the surface of tonsil in children and young adults. They usually present with sore throat and dysphagia. Tonsillectomy with excision of polyp is the curative treatment. Histopathological examination will aid in the final diagnosis. We report a case of an adult male with LAP of left tonsil, who presented with snoring, sore throat, and change of voice. How to cite this article Bhat SP, P Kamath SD, Rent NH, Shetty KC. Lymphangiomatous Polyp of the Tonsil: An Unusual Cause of Snoring. Int J Otorhinolaryngol Clin 2015;7(2):88-90.

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Not just a simple sore throat

Acute Medicine Journal ◽

10.52964/amja.0673 ◽

2017 ◽

Vol 16 (3) ◽

pp. 145-148

Author(s):

Olivia Jones ◽

◽

Aram Salehi ◽

Keyword(s):

Sore Throat ◽

Inflammatory Markers ◽

Jugular Vein ◽

Symptomatic Treatment ◽

Fusobacterium Necrophorum ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Persistent Symptoms ◽

Internal Jugular Vein Thrombosis ◽

Arcanobacterium Haemolyticum

The presentation of a ‘sore throat’ is common and often requires only symptomatic treatment. This is the case of a 20-year-old female who presented with persistent symptoms of a sore throat. On admission she had raised inflammatory markers and a subsequent blood culture demonstrated a fusobacterium necrophorum and arcanobacterium haemolyticum bacteraemia. Further investigations established an internal jugular vein thrombosis, confirming the diagnosis of Lemierre’s syndrome. This case highlights the importance of further investigation when a sore throat fails to improve, and to remember this often-forgotten syndrome.

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Prevalence of Fusobacterium necrophorum in persistent sore throat samples

British Journal of Biomedical Science ◽

10.1080/09674845.2011.11978256 ◽

2011 ◽

Vol 68 (4) ◽

pp. 209-210 ◽

Cited By ~ 5

Author(s):

S. L. Price ◽

S. Hardy ◽

P. Gale ◽

G. P. Basten

Keyword(s):

Sore Throat ◽

Fusobacterium Necrophorum

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Lemierre’s Syndrome

Journal of Infectious Diseases & Case Reports ◽

10.47363/jidscr/2021(2)144 ◽

2021 ◽

pp. 1-2

Author(s):

Abduallah Mawkili ◽

Keyword(s):

Young Adults ◽

Group A Streptococcus ◽

Fusobacterium Necrophorum ◽

Adolescents And Young Adults ◽

Lemierre’S Syndrome ◽

Gram Negative ◽

Negative Bacillus ◽

Gram Negative Bacillus ◽

Group A ◽

Lemierre's Syndrome

Fusobacterium necrophorum is a non-spore forming anaerobic gram-negative bacillus and has traditionally been associated with Lemierre’s syndrome, an infectious thrombophlebitis of the internal jugular vein.Fusobacterium necrophorum is commonly associated with pharyngitis, tonsillitis and peritonsillar abscesses similar to that of group A streptococcus, and is accounted for up to 10% of cases of pharyngitis in adolescents and young adults

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A rare, but life-threatening sore throat: A case of Lemierre’s syndrome

Acute Medicine Journal ◽

10.52964/amja.0844 ◽

2021 ◽

Vol 20 (1) ◽

pp. 78-82

Author(s):

A McCleane ◽

◽

M Hunter ◽

PC Johnston ◽

M Trimble ◽

...

Keyword(s):

Sore Throat ◽

Fusobacterium Necrophorum ◽

Lung Abscess ◽

Lemierre’S Syndrome ◽

Blood Tests ◽

Threatening Condition ◽

Life Threatening ◽

Lemierre's Syndrome ◽

Initial Blood ◽

Electrolyte Abnormalities

We present the case of a previously healthy, immunocompetent male with Lemierre’s Syndrome. He presented with headache, sore throat and pyrexia. Initial blood tests revealed raised inflammatory markers and electrolyte abnormalities. Blood cultured Fusobacterium necrophorum. He developed respiratory distress and imaging confirmed lung abscess and empyema due to septic emboli. He required surgical drainage and a prolonged course of antibiotics. This case highlights the rare, but life-threatening condition of Lemierre’s Syndrome. We discuss the importance of prompt recognition and early antibiotic therapy.

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