Bacterial Sepsis With Fusobacterium Species

Mitchell Shek, MD; Adil Karamali, MD; Nancy McGuire, MD; Paul Seifert, MD; Neil Alperin, MD
Arch Intern Med. 1988;148(10):2303. doi:10.1001/archinte.1988.00380100139036.
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To the Editor.  —Three cases of systemic bacterial sepsis with Fusobacterium species after infectious mononucleosis have been reported.1 All three patients were previously healthy young adults presenting with sore throat and fatigue. All had a diagnosis of infectious mononucleosis by Monospot test and, subsequently, required hospitalization. On admission, they had moderate-to-severe dehydration, respiratory distress, pharyngitis, and cervical lymphadenopathy. Abdominal pain and hepatosplenomegaly were inconsistent findings. In addition to the Monospot test, positive adsorption techniques, atypical lymphocytes on peripheral smear, elevated Epstein-Barr virus (EBV) titers, and the patients' clinical presentation were used to make the diagnosis of infectious mononucleosis. Decreased or low normal platelet counts were seen universally. All three patients eventually had positive blood cultures for Fusobacterium species, with two of three patients having Fusobacterium necroformans. We present an additional case of a previously healthy young female with elevated temperature, sore throat, cough, cervical lymphadenopathy, respiratory distress, septic pulmonary


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