INCIDENCE AND CLINICAL EPIDEMIOLOGY OF NECROBACILLOSIS, INCLUDING LEMIERRES-SYNDROME, IN DENMARK 1990-1995

To establish the incidence and describe the clinical epidemiology of n ecrobacillosis and Lemierre's syndrome in Denmark, the clinical record s of all laboratory-recorded cases of septicaemia due to Fusobacterium necrophorum biovar A, B, and C were reviewed retrospectively during a 6-year period. The incidence of necrobacillosis and Lemierre's syndro me was 1.5 and 0.8 per million persons per year, respectively, showing a tendency to increase during the period. Fusobacterium necrophorum w as grown after three days' incubation, but the characteristic pleomorp hic fusiform morphology was often disregarded as an important help in diagnosing necrobacillosis. The 24 patients with Lemierre's syndrome w ere all young and previously healthy, and none died, but pre-hospital delay was associated with a significantly higher morbidity and risk of metastatic infections. The remaining 25 patients with necrobacillosis had a high mortality, 24%, which was correlated with age and predispo sing diseases, especially cancers. These findings stress the importanc e of a quicker clinical and microbiological diagnosis in cases of Lemi erre's syndrome, and of screening for cancer in the remaining cases of necrobacillosis.