Methicillin-resistant Staphylococcus aureus bacteraemia associated with Lemierre's syndrome: case report and literature review

2013 ◽  
Vol 127 (7) ◽  
pp. 721-723 ◽  
Author(s):  
V Kizhner ◽  
G Samara ◽  
R Panesar ◽  
Y P Krespi
Keyword(s):  
Staphylococcus Aureus ◽  
Literature Review ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Blood Cultures ◽  
Health Concern ◽  
Lemierre’S Syndrome ◽  
Intravenous Antibiotic ◽  
Methicillin Resistant ◽  
The Past ◽  
Lemierre's Syndrome

AbstractBackground:Community-acquired methicillin-resistant Staphylococcus aureus is a growing health concern. Lemierre's syndrome is a septic jugular thrombophlebitis that primarily affects young adults. This paper aimed to identify a possible sub-group of Lemierre's syndrome cases associated with community-acquired methicillin-resistant Staphylococcus aureus.Method:This paper reports the case of a 16-year-old male who was admitted for increasing fever, tachycardia, tachypnoea and neck pain. The patient was diagnosed with methicillin-resistant Staphylococcus aureus bacteraemia associated with Lemierre's syndrome. A literature review was subsequently conducted.Results:Following intravenous antibiotic treatment and the sterilisation of blood cultures, the patient improved. The literature review indicated a rise in the past 2 years of Lemierre's syndrome associated with methicillin-resistant Staphylococcus aureus among patients less than 18 years of age.Conclusion:Community-acquired methicillin-resistant Staphylococcus aureus bacteraemia can lead to pulmonary sequelae. When it is associated with pharyngitis, nasopharyngitis or parapharyngeal lymphadenitis, the affected patient may be predisposed to Lemierre's syndrome. As bacterial carriage is predominantly nasal, pharyngitis may not be present. Methicillin-resistant Staphylococcus aureus should be included as an offending bacterium where there is suspicion of Lemierre's syndrome. It is unclear whether anticoagulation alters the course of the bacterium, and surgery is probably contraindicated.

scholarly journals Lemierre’s Syndrome Due to Methicillin-Resistant Staphylococcus aureus

2019 ◽  
Vol 7 ◽  
pp. 232470961989096
Author(s):  
Rolando A. Zamora Gonzalez ◽  
Juan C. Sarria ◽  
Nicole A. Christians ◽  
Michelle Baliss
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Methicillin Resistant ◽  
Septic Emboli ◽  
Vein Thrombosis ◽  
Etiologic Agents ◽  
Appropriate Treatment ◽  
Lemierre's Syndrome

Lemierre’s syndrome is an uncommon and potentially fatal complication of oropharyngeal and facial infections. It involves an associated septic thrombophlebitis, bacteremia, and septic emboli. Traditionally, compromise of the internal jugular vein has been described in conjunction with an infection caused by anaerobes, especially, Fusobacterium necrophorum. In recent years, however, variant forms have been appearing, including other vessel compromise and other etiologic agents. We present the case of Lemierre’s syndrome in a 31-year-old male with facial vein thrombosis, septic emboli to the lungs, and bacteremia caused by methicillin-resistant Staphylococcus aureus. We hope that this case will raise awareness about variant presentations and promote a timely diagnosis and appropriate treatment of this potentially fatal infection.

scholarly journals Methicillin-Resistant Staphylococcus aureus USA300 Clone as a Cause of Lemierre's Syndrome

2011 ◽  
Vol 49 (5) ◽  
pp. 2063-2066 ◽  
Author(s):  
J. M. Chanin ◽  
L. A. Marcos ◽  
B. M. Thompson ◽  
R. D. Yusen ◽  
W. M. Dunne ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Lemierre’S Syndrome ◽  
Methicillin Resistant ◽  
Usa300 Clone ◽  
Lemierre's Syndrome

Recurrent Methicillin-Resistant Staphylococcus Aureus Osteomyelitis: Combination Antibiotic Therapy with Evaluation by Serum Bactericidal Titers

1995 ◽  
Vol 29 (7-8) ◽  
pp. 694-697 ◽  
Author(s):  
Sherrie L Aspinall ◽  
David M Friedland ◽  
Victor L Yu ◽  
John D Rihs ◽  
Robert R Muder
Keyword(s):  
Staphylococcus Aureus ◽  
Back Pain ◽  
Antibiotic Therapy ◽  
Sedimentation Rate ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Blood Cultures ◽  
Low Back ◽  
Methicillin Resistant ◽  
Trough Concentrations

Objective: To report on a patient with recurrent methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis and bacteremia successfully treated with combination antibiotic therapy. Case Summary: Two sets of blood cultures from a 55-year-old man with fever, malaise, and low back pain grew MRSA. Radiologic studies of the spine showed bony changes consistent with osteomyelitis. Soon after completing 6 weeks of vancomycin, the patient experienced a recurrence of back pain. Laboratory values included an increase in the sedimentation rate to 53 mm/h and positive blood cultures for MRSA. Vancomycin, gentamicin, and rifampin were administered for 8 weeks. Serum inhibitory and bactericidal titers were more than 1:1024 for both the peak and trough concentrations. Radiologic studies of the spine showed healing osteomyelitis. Two years after completion of antibiotic therapy, the infection has not recurred. Discussion: Antibiotic therapy alone was attempted because the patient was considered a risky surgical candidate. Serum inhibitory and bactericidal titers documented the high in vivo activity of the vancomycin, gentamicin, and rifampin combination. Initiation of vancomycin therapy led to disappearance of the fever and back pain. Cure was documented by sustained normalization of the erythrocyte sedimentation rate and radiologic evidence of healing. Conclusions: Combination antibiotic therapy with vancomycin, rifampin, and low-dose gentamicin (1 mg/kg q12h) may be useful for deep-seated tissue infection caused by MRSA.

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