Lemierre’s syndrome: a forgotten life-threatening entity

2020 ◽  
Vol 13 (10) ◽  
pp. e236201
Author(s):  
Rita Gama ◽  
Manuel Sousa ◽  
Fernanda Castro ◽  
Artur Condé
Keyword(s):  
Jugular Vein ◽  
Final Diagnosis ◽  
Fusobacterium Necrophorum ◽  
Peritonsillar Abscess ◽  
Adult Males ◽  
Lemierre’S Syndrome ◽  
Family Doctors ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
Nose And Throat

Lemierre’s syndrome is a very rare but potentially fatal condition. It mainly affects adolescents and young adult males, and usually arises as a serious complication of pharyngitis or peritonsillar abscess. It is characterised by the triad of internal jugular vein septic thrombophlebitis, septic emboli (mostly pulmonary) and the isolation of the agent ‘Fusobacterium necrophorum’ in sterile fluids. In this report, it is described a case in which the nonspecific and subtle clinic made the diagnosis difficult to reach. In fact, only the dissociation between flu-like symptoms and the presence of significant changes in the blood tests (suggestive of acute bacterial infection), led to the request for imaging tests, which proved to be essential for the final diagnosis and subsequent control of the disease. This case report aims to increase the awareness among Ear, Nose and Throat (ENT) residents, paediatricians and family doctors about the existence of this entity and its potential life-threatening nature.

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.

A Rare Case of Lemierre’s Syndrome in a Male Division I Collegiate Football Player

2015 ◽  
Vol 20 (5) ◽  
pp. 11-15
Author(s):  
Heather Fahsl ◽  
Shannon David
Keyword(s):  
Signs And Symptoms ◽  
Fusobacterium Necrophorum ◽  
Football Player ◽  
Peritonsillar Abscess ◽  
Division I ◽  
Lemierre’S Syndrome ◽  
Night Sweats ◽  
Lemierre's Syndrome ◽  
Collegiate Football ◽  
Nose And Throat

During the fall preseason of 2013, a 19-year-old Division I linebacker (body mass = 104 kg; height = 189 cm) attending a college football camp developed severe throat pain, quickly followed by night sweats, fever, nausea, vomiting, shortness of breath, and generalized body weakness. The athletic trainer believed that the athlete had a cold. Because symptoms did not improve, the athlete was referred to several physicians with different specialties and underwent standard testing. The ears, nose, and throat (ENT) physician recognized the signs and symptoms of Lemierre’s syndrome based on a previous case seen only once in his career. A computed tomography (CT) scan confirmed the presence of a peritonsillar abscess and thrombosis of the left internal jugular vein, which justified further investigation for this rare syndrome. A positive blood culture for Fusobacterium necrophorum confirmed the diagnosis of Lemierre’s syndrome. Several antibiotics and anticoagulation medications were prescribed and the athlete was closely monitored. After two months, he was cleared to play football.

scholarly journals Abdominal variant of Lemierre’s Syndrome in a Patient with Pancreatic Adenocarcinoma

2021 ◽  
Author(s):  
Yavuz Furuncuoğlu ◽  
Bala Başak Oven ◽  
Başak Mert ◽  
Enis Çağatay Yılmaz ◽  
Mustafa Kemal Demir
Keyword(s):  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Infectious Agents ◽  
Resonance Imaging ◽  
Lemierre’S Syndrome ◽  
Gastrointestinal Malignancies ◽  
Life Threatening ◽  
Weighted Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Lemierre's Syndrome

Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre’s syndrome. Patients with gastrointestinal malignancies, especially those who undergo surgeries, are susceptible to the abdominal variant of Lemierre’s syndrome. Timely diagnosis is required to avoid the life-threatening complications of the abdominal variant of Lemierre’s syndrome. Diffusion-weighted magnetic resonance imaging (MRI) might be very useful in differentiating this disease from liver metastasis in patients with malignancies. Radiologists and clinicians need to be aware of this challenging condition to prevent misdiagnosis, since prompt treatment is often lifesaving.

scholarly journals Lemierre’s Syndrome: Case Presentation of a Rare and Possibly Life-Threatening Condition

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1102
Author(s):  
Lucian Giubelan ◽  
Livia Dragonu ◽  
Vlad Pădureanu ◽  
Alexandru Neacșu ◽  
Mirela Mănescu ◽  
...  
Keyword(s):  
Jugular Vein ◽  
Anaerobic Bacteria ◽  
Rare Condition ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Case Presentation ◽  
Oropharyngeal Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Lemierre's Syndrome

Lemierre’s syndrome is, presently, a very rare condition, but a life-threatening one. The syndrome was first described in 1936 by Andre Lemierre and comprises an oropharyngeal infection (most commonly associated with anaerobic bacteria Fusobacterium necrophorum), internal jugular vein thrombophlebitis and, possibly, secondary septic metastasis (common sites are lungs or brain). We describe such a rare case diagnosed at our Infectious Diseases Department in September 2019.

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 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 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.

A rare, but life-threatening sore throat: A case of Lemierre’s syndrome

2021 ◽  
Vol 20 (1) ◽  
pp. 78-82
Author(s):  
A McCleane ◽  
◽  
M Hunter ◽  
PC Johnston ◽  
M Trimble ◽  
...  
Keyword(s):  
Sore Throat ◽  
Fusobacterium Necrophorum ◽  
Lung Abscess ◽  
Lemierre’S Syndrome ◽  
Blood Tests ◽  
Threatening Condition ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
Initial Blood ◽  
Electrolyte Abnormalities

We present the case of a previously healthy, immunocompetent male with Lemierre’s Syndrome. He presented with headache, sore throat and pyrexia. Initial blood tests revealed raised inflammatory markers and electrolyte abnormalities. Blood cultured Fusobacterium necrophorum. He developed respiratory distress and imaging confirmed lung abscess and empyema due to septic emboli. He required surgical drainage and a prolonged course of antibiotics. This case highlights the rare, but life-threatening condition of Lemierre’s Syndrome. We discuss the importance of prompt recognition and early antibiotic therapy.

scholarly journals Lemierre’s Syndrome Associated with Mechanical Ventilation and Profound Deafness

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Lukas Birkner
Keyword(s):  
Mechanical Ventilation ◽  
Cochlear Implant ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Oropharyngeal Infection ◽  
Profound Deafness ◽  
Ventilation Support ◽  
Mechanical Ventilation Support ◽  
Life Threatening ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare disorder that is characterized by anaerobic organisms inducing a thrombophlebitis of the internal jugular vein (IJV) following a course of oropharyngeal infection. It often occurs in young and healthy patients. Clinicians continuously misinterpret early symptoms until infection disseminates systematically and life-threatening sepsis transpires. We report the case of a 58-year-old female developing Lemierre’s syndrome accompanied by invasive ventilation support and a profound deafness requiring the implementation of a cochlear implant. This is one of two reported cases of Lemierre’s syndrome associated with mechanical ventilation support and the only case associated with a cochlear implant.

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.

Sign in / Sign up

Export Citation Format

Share Document