OBJECTIVE: To assess the apparent increase in the diagnosis of Lemierre syndrome 
(LS) and other Fusobacterium necrophorum infections at a large children's 
hospital. Infections with F necrophorum ranged from peritonsillar abscess to 
potentially fatal LS. LS is an oropharyngeal infection characterized by septic 
thrombophlebitis of head and neck veins, complicated by dissemination of septic 
emboli to pulmonary and systemic sites.
METHODS: Review of the medical and laboratory records was conducted of all 
patients who were seen at or admitted to the Children's Hospital of Wisconsin 
with the diagnosis of LS and/or isolation of F necrophorum from a clinical 
specimen between January 1995 and January 2002.
RESULTS: During the 7-year period of the study, there was an increase in the 
isolation of F necrophorum from patients who were seen at Children's Hospital of 
Wisconsin, as well as the number of cases of LS. There was 1 isolation of F 
necrophorum from clinical specimens per year from 1996 to 1999, which increased 
to 10 isolates of the organism from January 2000 to January 2002. During the 
most recent period, January 2001-January 2002, 5 cases of LS were diagnosed, a 
distinctive entity not recognized previously at the institution.
CONCLUSIONS: The cause for the recent increase in the number of serious 
infections caused by F necrophorum infection diagnosed at our institution is 
unclear but does not seem to be related to changes in microbiologic techniques 
or patient demography. We speculate that it could be attributable, in part, to 
alterations in antibiotic usage patterns in our region. Clinicians need to be 
aware of the increasing clinical importance of F necrophorum infections and the 
life-threatening nature of LS.