More evidence on suppurative complications from Fusobacterium necrophorum tonsillitis

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密歇根大学耳鼻喉科的作者最近发表了一篇引人入胜的文章,题目是蕴涵Fusobacterium necrophorumin recurrence of peritonsillar abscess.This article adds to the emerging story of the dangers of incompletely treatedFusobacterium necrophorumpharyngitis.

This article has a wonderful discussion section (of course they cite our work favorably).The gist of the article is included in the abstract :

在我们的研究中,990名患者中有156名出现脓肿复发(16%)。The age ranges most susceptible to recurrence included adolescent (22.9%) and young adult groups (17.1%) … The presence of FN was significantly more prevalent in the recurrent group (P?

This article adds to our 必威体育understanding of who develops peritonsillar abscess (PTA).26% were in the 13-18 age group and 44% in the 19-30 age group.13-18岁组不相称地发展为复发性PTA。

本文支持显示Fusobacterium necrophorum作为PTA中最常见的培养菌(31%)。65%的复发性PTA在其原始培养中有FN。

This study adds to our clinical 必威体育understanding of the devastating potential of this gram negative anaerobic bacteria.We have previously found that FN pharyngitis has the same clinical presentation as strep pharyngitis.我们的微生物组研究表明,临床上更严重的咽炎患者(定义为中枢评分3或4分)在A组和B组之间存在差异。Fusobacterium necrophorum.The tonsils with FN infection had a less bacterial diversity – this means that FN overwhelms the microbiome in many such patients.

这些发现提示FN更可能引起化脓性并发症。We know from the Cochrane analysis that antibiotics decrease the risk of PTA independent of group A strep testing.这篇文章增加了我们对如何诊断和治疗的日益关注Fusobacterium necrophorumpharyngitis.

本文不讨论勒米埃综合征。We do know that this syndrome most often follows FN pharyngitis.We cannot prove that appropriate antibiotics would prevent the syndrome,但是你也不能提供任何证据证明抗生素不会减少这种综合征。

As the article documents,the epidemiology of FN pharyngitis,PTA和Lemierre综合征几乎完全重叠。这些感染主要发生在青少年和年轻人身上。While different articles have differing specific age ranges,one can easily generalize to around 15-30 year old patients.This large age group deserves a different approach to sore throats.我们只能希望idsa和cdc能够研究越来越多的证据,为这些患者的喉咙痛的诊断和治疗制定新的指导方针。

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