scholarly journals Isolated Facial Vein Thrombophlebitis: A Variant of Lemierre Syndrome

2014 ◽  
Vol 1 (2) ◽  
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.

scholarly journals A Rare Case Report of Lemierre Syndrome from the Anterior Jugular Vein

2020 ◽  
Vol 4 (3) ◽  
pp. 454-457
Author(s):  
Nima Rejali ◽  
Marissa Heyer ◽  
Doug Finefrock
Keyword(s):  
Case Report ◽  
Internal Jugular Vein ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Jugular Vein ◽  
Anticoagulation Therapy ◽  
Fusobacterium Necrophorum ◽  
Lemierre Syndrome ◽  
Septic Emboli ◽  
Radiologic Findings

Introduction: Lemierre syndrome is a rare, potentially fatal, septic thrombophlebitis of the internal jugular vein. Treatment includes intravenous antibiotics for Fusobacterium necrophorum, the most common pathogen, as well as consideration for anticoagulation therapy. Case Report: A 27-year-old female presented with left-sided neck swelling and erythema. Computed tomography noted left anterior jugular vein thrombophlebitis and multiple cavitating foci, consistent with septic emboli. We report a rare case of Lemierre syndrome in which the thrombus was found in the anterior jugular vein, as opposed to the much larger internal jugular vein more traditionally associated with creating septic emboli. Conclusion: Based on an individual’s clinical symptoms, history, and radiologic findings, it is important for physicians to consider Lemierre syndrome in the differential diagnosis, as the condition may rapidly progress to septic shock and death if not treated promptly. The use of anticoagulation therapy remains controversial, and there is a lack of established standard care because the syndrome is so rare.

Lemierre Syndrome: Not So Forgotten!

2014 ◽  
Vol 23 (2) ◽  
pp. 176-179 ◽  
Author(s):  
Nishant Gupta ◽  
Stephen M. Kralovic ◽  
Dennis McGraw
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Lymphatic Vessels ◽  
Fusobacterium Necrophorum ◽  
Septic Thrombophlebitis ◽  
Lemierre Syndrome ◽  
Travel History ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Bedside Ultrasonography

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.

Lemierre syndrome leading to an ischaemic stroke and malignant cerebral oedema

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.

Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report

2007 ◽  
Vol 122 (5) ◽  
pp. 527-530 ◽  
Author(s):  
S Georgopoulos ◽  
S Korres ◽  
M Riga ◽  
D Balatsouras ◽  
G Kotsis ◽  
...  
Keyword(s):  
Case Report ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Consumption Coagulopathy ◽  
Lemierre’S Syndrome ◽  
Acute Tonsillitis ◽  
Respiratory Deficiency ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
High Index Of Suspicion

AbstractBackground:Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.Case report:The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.Conclusion:The usual causative pathogen, namelyFusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.

P015: Lemierre Syndrome: A Rare Complication of Acute Tonsillitis

2006 ◽  
Vol 135 (2_suppl) ◽  
pp. P219-P219
Author(s):  
Petra U Lohnstein ◽  
Carsten Christof Boedeker ◽  
Joerg Schipper ◽  
Wolfgang Maier
Keyword(s):  
Rare Complication ◽  
Acute Tonsillitis ◽  
Lemierre Syndrome

scholarly journals Lemierre Syndrome: Two Preschool Children with Cerebral Infarcts

2008 ◽  
Vol 1 ◽  
pp. CMPed.S879
Author(s):  
Miriam Santschi ◽  
Michèle David ◽  
Laurent Garel ◽  
Michel Vanasse ◽  
France Gauvin
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Left Internal Jugular Vein ◽  
Cerebral Infarcts ◽  
Jugular Vein Thrombosis ◽  
Lemierre Syndrome ◽  
Vein Thrombosis ◽  
First Case ◽  
One Year

We report two children who developed hemiparesis secondary to cerebral infarcts complicating Lemierre syndrome. The first case is a one-year-old patient who presented a left internal jugular vein thrombosis and a left carotid compression due to retropharyngeal cellulitis. The second case is a five-year-old girl who presented a left internal jugular vein and a right carotid artery thrombosis associated with an oropharyngeal cellulitis. Etiologic agents involved were Staphylococus aureus in the first case and Fusobacterium necrophorum in the second case. These cases call for vigilance among physicians for this rare syndrome, its unusual presentation and its associated severe complications.

scholarly journals Lemierre Syndrome: Clinical Update and Protocol for a Systematic Review and Individual Patient Data Meta-analysis

2018 ◽  
Vol 39 (01) ◽  
pp. 076-086 ◽  
Author(s):  
Clara Sacco ◽  
Federica Zane ◽  
Serena Granziera ◽  
Karin Holm ◽  
Dina Creemers-Schild ◽  
...  
Keyword(s):  
Systematic Review ◽  
Individual Patient Data ◽  
Jugular Vein ◽  
Meta Analysis ◽  
Management Strategies ◽  
Fusobacterium Necrophorum ◽  
Patient Data ◽  
Lemierre Syndrome ◽  
Vein Thrombosis ◽  
Starting Point

AbstractLemierre syndrome usually affects otherwise healthy adolescents or young adults and occurs at an overall rate of 1 to 10 cases per million person-years with an estimated fatality rate of 4 to 9%. Diagnostic criteria remain debated and include acute neck/head bacterial infection (often tonsillitis caused by anaerobes at high potential for sepsis and vascular invasion, notably Fusobacterium necrophorum) complicated by local vein thrombosis, usually involving the internal jugular vein, and systemic septic embolism. Medical treatment is based on antibiotic therapy with anaerobic coverage, anticoagulant drugs and supportive care in case of sepsis. Surgical procedures can be required, including drainage of the abscesses, tissue debridement and jugular vein ligation. Evidence for clinical management is extremely poor in the absence of any adequately sized study with clinical outcomes. In this article, we illustrate two cases of Lemierre syndrome not caused by Fusobacterium necrophorum and provide a clinically oriented discussion on the main issues on epidemiology, pathophysiology and management strategies of this disorder. Finally, we summarize the study protocol of a proposed systematic review and individual patient data meta-analysis of the literature. Our ongoing work aims to investigate the risk of new thromboembolic events, major bleeding or death in patients diagnosed with Lemierre syndrome, and to better elucidate the role of anticoagulant therapy in this setting. This effort represents the starting point for an evidence-based treatment of Lemierre syndrome built on multinational interdisciplinary collaborative studies.

scholarly journals Thoracic Complications of Lemierre Syndrome

2000 ◽  
Vol 7 (6) ◽  
pp. 481-485 ◽  
Author(s):  
Russell Thomas Gowan ◽  
Reza John Mehran ◽  
Pierre Cardinal ◽  
Gwynne Jones
Keyword(s):  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Review Of The Literature ◽  
Septic Thrombophlebitis ◽  
Lemierre Syndrome ◽  
Gram Negative ◽  
Negative Bacillus ◽  
Oropharyngeal Infection ◽  
Gram Negative Bacillus ◽  
The Subject

Lemierre syndrome is a severe, septicemic illness most commonly caused by the anaerobic Gram-negative bacillusFusobacterium necrophorum. It is characterized by an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. This report of a patient with the Lemierre syndrome is complemented by a review of the literature on the subject.

scholarly journals Lemierre syndrome presenting as acute mastoiditis in a 2-year-old girl with congenital dwarfism

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Jason B. Fischer ◽  
Andrew Prout ◽  
R. Alexander Blackwood ◽  
Kavita Warrier
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Septic Thrombophlebitis ◽  
Computed Tomography Scan ◽  
Older Children ◽  
Acute Mastoiditis ◽  
Lemierre Syndrome ◽  
Congenital Dwarfism ◽  
Tomography Scan

Lemierre syndrome is defined by septic thrombophlebitis of the internal jugular vein caused by <em>Fusobacterium</em>. Historically, these infections originate from the oropharynx and typically are seen in older children, adolescents and young adults. More recently, otogenic sources in younger children have been described with increasing frequency. We present a case of a two-year old, who initially developed an otitis media with perforation of the tympanic membrane and went on to develop mastoiditis and non-occlusive thrombosis of the venous sinus and right internal jugular vein. <em>Fusobacterium necrophorum</em> was grown from operative cultures of the mastoid, ensuing computed tomography scan revealed occlusion of the internal jugular vein and the patient was successfully treated with clindamycin, ciprofloxacin and enoxaparin. This case demonstrates the importance of considering <em>Fusobacterium</em> in otogenic infections and the consideration of Lemierre syndrome when <em>F. necrophorum</em> is identified.

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