scholarly journals Human Infection with Fusobacterium necrophorum (Necrobacillosis), with a Focus on Lemierre's Syndrome

2007 ◽  
Vol 20 (4) ◽  
pp. 622-659 ◽  
Author(s):  
Terry Riordan
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Antibiotic Use ◽  
Fusobacterium Necrophorum ◽  
Human Infection ◽  
Upper Respiratory Tract ◽  
Recurrent Tonsillitis ◽  
Lemierre’S Syndrome ◽  
Source Of Infection ◽  
Lemierre's Syndrome

SUMMARYSummary:Human infection withFusobacterium necrophorumusually involvesF. necrophorumsubsp.funduliformerather thanF. necrophorumsubsp.necrophorum, which is a common pathogen in animals. Lemierre's syndrome, or postanginal sepsis, is the most common life-threatening manifestation. Tonsillitis is followed by septic thrombophlebitis of the internal jugular vein and then a septicemia with septic emboli in lungs and other sites. Recent evidence suggests thatF. necrophorumcan be limited to the throat and cause persistent or recurrent tonsillitis.F. necrophorumis unique among non-spore-forming anaerobes, first for its virulence and association with Lemierre's syndrome as a monomicrobial infection and second because it seems probable that it is an exogenously acquired infection. The source of infection is unclear; suggestions include acquisition from animals or human-to-human transmission. Approximately 10% of published cases are associated with infectious mononucleosis, which may facilitate invasion. Recent work suggests that underlying thrombophilia may predispose to internal jugular vein thrombophlebitis. Lemierre's syndrome was relatively common in the preantibiotic era but seemed to virtually disappear with widespread use of antibiotics for upper respiratory tract infection. In the last 15 years there has been a rise in incidence, possibly related to restriction in antibiotic use for sore throat.

scholarly journals Human Infection withFusobacterium necrophorumwithout Jugular Venous Thrombosis: A Varied Presentation of Lemierre’s Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Muhammad Asim Rana ◽  
Yashwant Kumar ◽  
Abdullah Ali Lashari ◽  
Ahmed F. Mady
Keyword(s):  
Nerve Palsy ◽  
Jugular Vein ◽  
Kidney Injury ◽  
Severe Pneumonia ◽  
Fusobacterium Necrophorum ◽  
Human Infection ◽  
Upper Respiratory Tract ◽  
Lemierre’S Syndrome ◽  
Upper Respiratory ◽  
Lemierre's Syndrome

Lemierre’s syndrome is also known as postangina septicemia, which is commonly caused byFusobacterium necrophorumalso known as Necrobacillus and also by other microorganisms likeStaphylococcus,Streptococcus,Peptostreptococcus, andBacteroides. Though the disease starts as an upper respiratory tract infection, it may spread and cause thrombophlebitis of the internal jugular vein. It may present itself through cranial nerve palsy or sepsis involving distant organs like the lungs or bones. It is also known as forgotten disease because of its rarity.Fusobacterium necrophorumusually causes infection in animals and rarely affects humans. We hereby present a case of Necrobacillus infection which did not cause any thrombophlebitis but resulted in severe pneumonia and acute kidney injury, leading to respiratory failure and requiring mechanical ventilation.

scholarly journals Bilateral Lemierre's Syndrome: A Case Report and Literature Review

2002 ◽  
Vol 81 (4) ◽  
pp. 234-252 ◽  
Author(s):  
Brian A. Moore ◽  
Catherine Dekle ◽  
Jay Werkhaven
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Jugular Veins ◽  
Vein Thrombosis ◽  
Warfarin Sodium ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Lemierre's syndrome is characterized by thrombosis of the internal jugular vein that develops following an oropharyngeal infection. Sepsis and septic metastases frequently ensue and affect the lungs, the musculoskeletal system, and occasionally the liver. Most cases are caused by infection with Fusobacterium necrophorum. This infection responds to antibiotic therapy with beta-lactamase-resistant compounds that exert good anaerobic coverage. Anticoagulation and surgical intervention can be helpful in advanced cases. Fewer than 160 cases of classic Lemierre's syndrome have been described; approximately one-third of these reported cases have occurred since 1988. We describe a new case of Lemierre's syndrome that occurred in an otherwise healthy 27-year-old man. Thrombosis of both internal jugular veins extended through the subclavian system and into both upper extremities. The patient was treated with intravenous antibiotics and heparin during 14 days of hospitalization. He was discharged on oral clindamycin and warfarin sodium, and after 6 months he was able to return to full activity. To our knowledge, this is the first reported case of Lemierre's syndrome in which internal jugular vein thrombosis occurred bilaterally. By reporting this previously undescribed manifestation of Lemierre's syndrome, we hope to increase practitioner awareness of this disease entity.

scholarly journals Porphyromonas asaccharolytica as a Rare Causative Agent for Lemierre’s Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Mridul Gupta ◽  
Radhika Annam ◽  
Joseph Bahgat ◽  
Margaret Eng
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Left Internal Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Acute Tonsillitis ◽  
Oropharyngeal Infection ◽  
Oropharyngeal Flora ◽  
Distant Spread ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare disease associated with significant morbidity and mortality. It begins with an oropharyngeal infection, which spreads locally to involve the internal jugular vein causing thrombophlebitis, followed by distant spread and metastatic infections. Affected individuals are commonly young adults. Causative organisms are usually oropharyngeal flora, most commonly being the anaerobe Fusobacterium necrophorum. Porphyromonas asaccharolytica is a rare etiological agent with only three cases being reported in the literature. This case report describes a previously healthy 22-year-old man who initially presented with acute tonsillitis and was later found to have left internal jugular vein thrombophlebitis along with bilateral septic emboli to the lungs. The patient was treated with a five-week course of ampicillin-sulbactam and metronidazole. Subsequent imaging also showed progression of internal jugular vein thrombus, for which warfarin was given for three months for anticoagulation.

Lemierre’s syndrome

2021 ◽  
pp. practneurol-2021-002928
Author(s):  
Eng Chuan Foo ◽  
Matthew Tanti ◽  
Helen Cliffe ◽  
Marc Randall
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Cervical Lymphadenopathy ◽  
Fusobacterium Necrophorum ◽  
Good Prognosis ◽  
Hemicrania Continua ◽  
Lemierre’S Syndrome ◽  
Presenting Symptoms ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare and potentially life-threatening condition that follows an oropharyngeal infection, typically from Fusobacterium necrophorum, and usually affects healthy adolescents or young adults. The characteristic features are septic thrombophlebitis of the internal jugular vein and septic embolism leading to multiorgan involvement, commonly the brain, lungs and bones. We report a man with presenting symptoms suggesting hemicrania continua, whose initial imaging showed no features of dural venous sinus or jugular thrombosis. Two weeks later, he had fever, sore throat, cervical lymphadenopathy and Actinomyces meyeri grew from peripheral blood cultures. Further imaging identified thrombosis of the internal jugular vein and cerebral venous sinuses, with multifocal cavitating lung lesions. Following antibiotics and anticoagulation, he recovered without residual deficits. Lemierre’s syndrome when recognised and treated early has a good prognosis but delayed treatment may result in significant morbidity or mortality.

Lemierre’s syndrome as a consequence of acute supraglottitis

2002 ◽  
Vol 116 (3) ◽  
pp. 216-218 ◽  
Author(s):  
Andrew Hope ◽  
Nigel Bleach ◽  
Sabour Ghiacy
Keyword(s):  
Computed Tomography ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Intravenous Antibiotics ◽  
Intracranial Thrombosis ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

Lemierre’s syndrome comprises internal jugular vein thrombosis following oropharyngeal sepsis and is a rare and serious condition. It is most commonly caused by the anaerobe Fusobacterium necrophorum and typically presents as metastatic sepsis to the lungs and joints. Thrombosis is demonstrated by computed tomography (CT) of the neck, and it is routinely treated with intravenous antibiotics and anti-coagulation.We describe a case of Lemierre’s syndrome following acute supraglottitis. The clinical features were of retrograde intracranial thrombosis, rather than the more usual metastatic sepsis.

scholarly journals Acute neck pain referred to the surgeon: Lemierre's syndrome as a differential diagnosis

2012 ◽  
Vol 94 (3) ◽  
pp. e132-e133 ◽  
Author(s):  
D Chattopadhyay ◽  
ML Mostafa ◽  
M Carr
Keyword(s):  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Neck Pain ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Lemierre's Syndrome ◽  
Acute Neck Pain

Lemierre's syndrome is usually reported in the young and in fit individuals. We report a case of an 81-year-old woman who presented with thrombophlebitis of the internal jugular vein with a pulmonary embolism.

scholarly journals Lemierre’s Syndrome: A Neglected Disease with Classical Features

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Andreas V. Hadjinicolaou ◽  
Yiannis Philippou
Keyword(s):  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Blood Cultures ◽  
Inotropic Support ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Intensive Care Admission ◽  
Vein Thrombosis ◽  
History Of ◽  
Lemierre's Syndrome

We report the case of a previously healthy, immunocompetent 23-year-old male who presented to the Emergency Department with general malaise, difficulty in breathing, fever, and chest pain. He reported a two-week history of progressively worsening sore throat that he presumed to be a viral infection and thus initially neglected. However, when his condition deteriorated, he was admitted to hospital acutely unwell and in respiratory distress. He quickly developed septic shock requiring intensive care admission for inotropic support. Ultrasound and CT imaging revealed internal jugular vein thrombosis with associated septic emboli reaching the lungs to form bilateral cavitations and consequently pleural effusions. Blood cultures were positive forFusobacterium necrophorum. Based on these findings, a diagnosis of Lemierre’s syndrome was made. The patient was treated with appropriate antibiotics and anticoagulation and gradually recovered. He was discharged 20 days after admission with advice to complete a six-week course of antibiotics.

scholarly journals A Case of Lemierre Syndrome Secondary to Otitis Media and Mastoiditis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
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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