1. Introduction
Fusobacterium nucleatum was first reported as an anaerobic oral
commensal and a periodontal pathogen associated with multiple human
diseases, described for the first time in early 1900’s17. The pathogen has five proposed subspecies (ss):animalis, ss fusiforme, ss nucleatum, ss polymorphum, and ss
vincentii 15 and often present in small numbers as
part of the normal human throat flora15,10.
LS is a rare disease that presents in healthy young adults without any
underlying medical conditions8. LS is highly curable
if appropriate antibiotic therapy is administered on a timely basis. In
the pre-antibiotic era, LS was a common complication of pharyngitis with
poor prognosis, resulting in 90%-100% mortality.28Although the prompt use of β-lactam antibiotics have reduced the
incidence to 0.8 to 1.5 cases per million persons per year, LS still
remains a potentially life-threatening disease that results in a 15%
mortality rate.8, 16, 29 A study in Denmark revealed
the annual incidence of 14.4 cases per million people among young adults
aged 14-24 years old11. Lastly, surgical drainage of
abscesses is indicated for patients who fail to respond successfully to
antibiotics alone27. Although using anticoagulation in
LS is common, it remains controversial.
Moreover, it is important for physicians to include LS in their
differentials for patients presenting with toxic appearance, fever, sore
throat, respiratory distress and cough to ensure timely diagnosis of
this potentially life-threatening disease and start appropriate
microbiological therapy2.