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

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
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.

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.

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.

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

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

scholarly journals Head, Neck, and Abdominopelvic Septic Thrombophlebitis: Current Evidence and Challenges in Diagnosis and Treatment

2020 ◽  
Vol 40 (03) ◽  
pp. 301-310 ◽  
Author(s):  
Luca Valerio ◽  
Nicoletta Riva
Keyword(s):  
Observational Studies ◽  
Antimicrobial Agents ◽  
Jugular Vein ◽  
Assessment Tools ◽  
Current Evidence ◽  
Future Research ◽  
Septic Thrombophlebitis ◽  
Lemierre Syndrome ◽  
Patient Screening ◽  
Head Neck

AbstractSeptic thrombophlebitis (STP) is a complex, cross-disciplinary clinical condition that combines a localized infection with a neighboring venous thrombosis. STP can occur at several possible anatomic sites, such as dural sinuses, jugular vein (Lemierre syndrome), portal vein (pylephlebitis), and pelvic veins. Its high mortality in the preantibiotic era improved considerably with the introduction of modern antibiotics. However, little evidence exists to date to guide its clinical management. The incidence of STP or its risk factors may be increasing, and its mortality may still be considerable. These trends would have far-reaching implications, especially in the setting of increasing resistance to antimicrobial agents. No clinical assessment tools exist to support patient screening or guide treatment in STP. Few interventional studies exist on the efficacy and safety of anticoagulation. Recommendations on its indications, duration, and the agents of choice are mostly based on evidence derived from small observational studies. While all forms of STP pose similar challenges, future research may benefit from the distinction between bacteria-associated, virus-associated, and mycosis-associated thrombophlebitis. Addressing these gaps in evidence would enhance our ability to diagnose this condition and treat patients effectively.

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

2019 ◽  
Vol 2019 (7) ◽  
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.

Physiologic variations of the internal jugular vein surface, role of the omohyoid muscle, a preliminary echographic study

1988 ◽  
Vol 10 (2) ◽  
pp. 107-112 ◽  
Author(s):  
P. Patra ◽  
T. K. Gunness ◽  
R. Robert ◽  
J. M. Rogez ◽  
Y. Heloury ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Omohyoid Muscle

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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