Septic thrombosis of cavernous sinus extended to the ipsilateral internal jugular vein and transversal sinus with favorable outcome: Clinical and radiological features of a Lemierre syndrome

Lemierre syndrome is a rare and life-threatening illness. Often referred to as “the forgotten disease,” its incidence is reported to be as low as 1 in a million. The microorganism responsible for Lemierre syndrome is typically Fusobacterium necrophorum. The bacterium starts in the pharynx and peritonsillar tissue, then disseminates through lymphatic vessels. Severe sepsis rapidly develops, as does the hallmark of this syndrome: septic thrombophlebitis of the internal jugular vein. This report describes a case of Lemierre syndrome in a previously healthy 26-year-old man with life-threatening internal jugular vein thrombophlebitis following 2 weeks of an indolent course of pharyngitis. The patient’s initial presentation and extensive travel history as an Army veteran were particularly challenging aspects in establishing his diagnosis. The diagnosis of Lemierre syndrome is frequently delayed. Routine use of bedside ultrasonography may aid in rapid diagnosis of the disease.

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Bilateral Internal Jugular Vein Thrombosis: An Unusual Presentation of Lemierre Syndrome

Otolaryngology - Open Journal ◽

10.17140/otloj-2-115 ◽

2016 ◽

Vol 2 (2) ◽

pp. 70-72

Author(s):

Arpit Saxena ◽

◽

A V Ramesh ◽

Poonam Raj Mehra ◽

E. Nikhilesh ◽

...

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Unusual Presentation ◽

Jugular Vein Thrombosis ◽

Lemierre Syndrome ◽

Vein Thrombosis ◽

Internal Jugular Vein Thrombosis

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A case of Lemierre-like Syndrome: internal jugular vein thrombosis secondary to Staphylococcus aureus sternoclavicular joint septic arthritis

Oxford Medical Case Reports ◽

10.1093/omcr/omz059 ◽

2019 ◽

Vol 2019 (7) ◽

Cited By ~ 1

Author(s):

Chaozer Er ◽

Vanessa Hwee Ting Tey ◽

Navin Kuthiah ◽

Veeraraghavan Meyyur Aravamudan

Keyword(s):

Staphylococcus Aureus ◽

Septic Arthritis ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Sternoclavicular Joint ◽

Jugular Vein Thrombosis ◽

Lemierre Syndrome ◽

Vein Thrombosis ◽

Oropharyngeal Infection ◽

Responsible Pathogen

Abstract Lemierre syndrome is the internal jugular vein (IJV) suppurative thrombophlebitis, usually secondary to oropharyngeal infection. Staphylococcus aureus is an emerging responsible pathogen. We report a unique case of IJV thrombosis secondary to methicillin-susceptible S. aureus sternoclavicular joint septic arthritis. We review the existing literature on Lemierre syndrome: its various manifestations, causative pathogens, treatment and management.

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Isolated Facial Vein Thrombophlebitis: A Variant of Lemierre Syndrome

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu053 ◽

2014 ◽

Vol 1 (2) ◽

Cited By ~ 7

Author(s):

Kirstine K.S. Karnov ◽

Jacob Lilja-Fischer ◽

Thomas Skov Randrup

Keyword(s):

Blood Culture ◽

Anaerobic Bacterium ◽

Jugular Vein ◽

Rare Complication ◽

Fusobacterium Necrophorum ◽

Acute Tonsillitis ◽

Lemierre Syndrome ◽

Septic Emboli ◽

Facial Vein ◽

Septic Thrombosis

Abstract Lemierre syndrome is a rare complication of acute tonsillitis. It is caused by the anaerobic bacterium Fusobacterium necrophorum and is characterized by bacteremia and septic thrombosis of the internal jugular vein. Dissemination of septic emboli may occur. The diagnosis can be difficult since different organs can be involved. We discuss a case of Lemierre syndrome in a 35-year-old woman with isolated thrombophlebitis of the facial vein and fusobacteria growth in blood culture. This case emphasizes the need for awareness of the condition.

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A Case of Lemierre Syndrome Secondary to Otitis Media and Mastoiditis

Case Reports in Emergency Medicine ◽

10.1155/2014/208960 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Aynur Turan ◽

Harun Cam ◽

Yeliz Dadali ◽

Serdar Korkmaz ◽

Ali Özdek ◽

...

Keyword(s):

Otitis Media ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Anaerobic Bacteria ◽

Transverse Sinus ◽

Lemierre’S Syndrome ◽

Lemierre Syndrome ◽

Mortality And Morbidity ◽

Oropharyngeal Infection ◽

Lemierre's Syndrome

Lemierre’s syndrome is a rare clinical condition that generally develops secondary to oropharyngeal infection caused byFusobacterium necrophorum, which is an anaerobic bacteria. A 62-year-old patient with diabetes mellitus presented with internal jugular vein and sigmoid sinus-transverse sinus thrombophlebitis, accompanying otitis media and mastoiditis that developed after an upper airway infection. Interestingly, there were air bubbles in both the internal jugular vein and transverse sinus. Vancomycin and meropenem were started and a right radical mastoidectomy was performed. The patient’s clinical picture completely resolved in 14 days. High mortality and morbidity may be prevented with a prompt diagnosis of Lemierre’s syndrome.

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A Unique Case of Lemierre Syndrome Associated with Thrombophilia in an Adult and the Role of Anticoagulation

Case Reports in Medicine ◽

10.1155/2010/982494 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Pradeep H. Lakshminarayana ◽

Matthew E. Woodske

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Hypercoagulable State ◽

Rare Entity ◽

Septic Thrombophlebitis ◽

Unique Case ◽

Lemierre Syndrome ◽

Intravenous Antibiotics

Acute septic thrombophlebitis of the internal jugular vein (IJV), better known as Lemierre syndrome, is a rare entity which poses several challenges in management. Treatment involves prompt use of intravenous antibiotics over a prolonged period of time, typically 6–8 weeks. The use of anticoagulation is controversial, but indicated for some. We describe the first reported case of Lemierre syndrome associated with a hypercoagulable state in an adult. We propose that all patients with Lemierre syndrome should be evaluated for hypercoagulable states and that the indications for anticoagulation in Lemierre syndrome are (1) propagation or nonresolution of IJV thrombus despite antibiotics and (2) identification of a hypercoagulable state, as in our case.

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Lemierre syndrome leading to an ischaemic stroke and malignant cerebral oedema

BMJ Case Reports ◽

10.1136/bcr-2021-243690 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243690

Author(s):

Cesar Carballo Cuello ◽

Orlando De Jesus ◽

Eduardo J Labat ◽

Emil A Pastrana

Keyword(s):

Bacterial Infection ◽

Ischaemic Stroke ◽

Carotid Stenosis ◽

Internal Jugular Vein ◽

Decompressive Craniectomy ◽

Cerebral Oedema ◽

Jugular Vein ◽

Rare Complication ◽

Lemierre Syndrome

Lemierre syndrome is an often misdiagnosed disease caused by an anaerobic bacterial infection that produces thrombophlebitis of the internal jugular vein and septic metastasis to distal organs, especially the lungs. Carotid stenosis or thrombosis is a rare complication. We present a patient with Lemierre syndrome who developed malignant cerebral oedema secondary to an ischaemic stroke which required a decompressive craniectomy.

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Lemierre’s syndrome with cavernous sinus thrombosis caused by dental infection

BMJ Case Reports ◽

10.1136/bcr-2020-238521 ◽

2021 ◽

Vol 14 (3) ◽

pp. e238521

Author(s):

Peerawat Sukkul ◽

Narongrit Kasemsap

Keyword(s):

Internal Jugular Vein ◽

Cavernous Sinus ◽

Jugular Vein ◽

Sinus Thrombosis ◽

Cavernous Sinus Thrombosis ◽

Lemierre’S Syndrome ◽

Jugular Vein Thrombosis ◽

Septic Emboli ◽

Cavernous Sinus Syndrome ◽

Lemierre's Syndrome

Lemierre’s syndrome is a rare multisystemic infection beginning in oropharynx commonly caused by oral anaerobic organisms and leading to internal jugular vein thrombosis with septic emboli. Here, we describe a 45-year-old woman with hypertension and unrecognised type 2 diabetes who presented to a community hospital with fever, double vision and septic shock. Examination showed neck pain aggravated by neck flexion, limited ocular movement of right lateral rectus, left medial rectus and left superior oblique and incomplete ptosis of the left eye. These symptoms were suggestive of bilateral cavernous sinus syndrome. CT of the brain showed bilateral proximal internal jugular vein and cavernous sinus thrombosis. CT angiography revealed septic emboli at both upper lungs. The patient had good improvement of neurological symptoms after dental extraction, intravenous antibiotic and anticoagulant.

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