Necrobacillosis.

Fusobacterium necrophorum, an anaerobe for which numerous synonyms exists, causes a severe septicaemic illness in man. This, in common with various animal infections with the organism, has been called necrobacillosis. These septicaemias usually occur in previously healthy children and adolescents. A total of 45 cases were studied from over 20 hospitals in England and Wales. The commonest presentation (two thirds of cases) was of post-anginal septicaemia, in which a sore throat was followed by rigors and metastatic abscesses, usually in the lung, but also in bone, central nervous system and other sites. Multisystem disturbance was frequent. Other cases presented without a previous sore throat but with otitis, mastoiditis, sinusitis or dental infection, or with acute osteomyelitis. Two patients died of their infection. In those who survived, recovery was usually prolonged, despite appropriate antibiotics. In many cases there was considerable diagnostic confusion, and few doctors were familiar with the disease. F. necrophorum was often initially misidentified in the laboratory. Necrobacillosis is a serious, if uncommon, infection of healthy young people, it deserves wider recognition.