[Fusobacterium necrophorum--cause of a mastoiditis with skull- and mandibular joint osteomyelitis].

BACKGROUND The typical clinical manifestation of an infection with the obligate anaerobic, gram-negative, rod-shaped bacteria Fusobacterium necrophorum is the Lemierre syndrome. As the cause of osteomyelitis and mastoiditis factors of the normal bacteria flora are more likely to be found than Fusobacterium necrophorum. Nevertheless, Necrobacillosis is an important differential diagnosis of complicated courses of mastoiditis. MATERIAL AND METHODS Because the clinical courses of mastoiditis with osteomyelitis may differ a lot, making the appropriate diagnosis more difficult, consistently and flawless detection of the pathogens is important. Therefore a correct specimen collection, transportation and the subsequent cultivation of the pathogens is essential. RESULTS The genus Fusobacterium is an obligate anaerobic, gram-negative rod-shaped bacteria. Infections involving the genus Fusobacterium are usually formed endogenously. They are characterized by subacute to chronic, purulent gangrenous necrotizing inflammations. CONCLUSION As a differential diagnosis, infections with Streptococcus spp., Haemophilus influenzae, Branhamella catarrhalis and Staphylococcus aureus are more likely to cause mastoiditis and osteomyelitis than an infection with Fusobacterium necrophorum. However, the infection with this fusiform bacillus is possible under pathological circumstances e.g. deficiency syndroms, so that when observing a prolonged disease course of mastoiditis an infection with Fusobacterium necrophorum should be considered .