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.

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.

scholarly journals P.031 Lemierre’s syndrome - a rare disease with devastating complications

2016 ◽  
Vol 43 (S2) ◽  
pp. S28-S29
Author(s):  
S Alhusaini ◽  
S Althubait ◽  
C Melmed ◽  
M Sidel
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Cervical Lymphadenopathy ◽  
Kidney Injury ◽  
Neurological Complications ◽  
Initial Examination ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Background: Lemierre’s syndrome is a rare but serious complication of bacterial oropharyngeal infection. It is characterized by local spread of the primary infection, thrombophlebitis of the internal jugular vein, and septic metastases resulting in significant multi-system complications. Methods: A case report. Results: A previously healthy 63 year-old female presented to our emergency room with four-day history of sore throat, headache, fever and malaise. Initial examination revealed evidence of left tonsillar swelling and cervical lymphadenopathy. The patient rapidly deteriorated within hours of presentation and developed septic shock that was complicated by an acute kidney injury and disseminated intravascular coagulation (DIC). CT of the head and neck revealed a deep abscess within the left masticular triangle extending to surrounding soft tissue as well as C1-C3 epidural space. An extensive bilateral internal jugular vein thrombosis was noted; extending into the sigmoid and cavernous sinuses bilaterally. A thrombosis of the superior sagittal sinus and parafalcine subdural hematoma were also demonstrated. Blood cultures grew Group C Streptococcus. As the deep abscess was not amenable to surgical drainage, the patient was treated with broad-spectrum IV antibiotics. Anticoagulation was also commenced after management and resolution of the DIC. Conclusions: Lemierre’s syndrome remains relevant nowadays and awareness of its potential neurological complications is warranted.

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.

scholarly journals Internal Jugular Vein and Transverse Sinus Thrombosis as a Complication of a Chronic Ethmoidal Sinusitis

2017 ◽  
Vol 2 (3) ◽  
pp. 7-9
Author(s):  
Kombate Damelan ◽  
ASSOGBA Komi ◽  
kumako vinyo ◽  
Diatewa E. Josué ◽  
Guinhouya Kokou Mensah ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Oral Anticoagulant ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Oral Anticoagulant Therapy ◽  
Transverse Sinus ◽  
Lemierre’S Syndrome ◽  
Young Males ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Lemierre’s syndrome is rare jugular thrombosis associated with an oropharyngeal infection. The jugular thrombosis is from septic origin. This often happens in young males subjects. We described Lemierre’s syndrome in a 46 year-old man with a chronic ethmoidal sinusitis associated to the left jugular thrombosis extended to the transverse sinus with a partial recanalisation after three months of oral anticoagulant therapy.

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.

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.

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