scholarly journals Severe Sepsis Associated with Lemierre’s Syndrome: A Rare but Life-Threatening Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Audrey Tawa ◽  
Raphaëlle Larmet ◽  
Yannick Malledant ◽  
Philippe Seguin
Keyword(s):  
Fusobacterium Necrophorum ◽  
Blood Analysis ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
Lemierre’S Syndrome ◽  
Surgical Intensive Care ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Lemierre's Syndrome

Background.The incidence of Lemierre’s syndrome has increased in the past decade. This posttonsillitis complication may be life threatening.Case Presentation.A 19-year-old patient was admitted to Surgical Intensive Care Unit of a French University Hospital for high fever, low blood pressure, and haemoptysis following a sore throat episode. Blood analysis revealed a thrombopenia, an acute renal failure, and an elevated lactate serum.Fusobacterium necrophorumwas found in blood cultures. Computed tomography of the neck and lungs confirmed the diagnosis of Lemierre’s syndrome: pleural effusions, bilateral lung infiltrates, and an internal jugular vein thrombosis. Fluid administration and antibiotic treatment were quickly initiated. Patient left the unit four days after his admission without any organ dysfunction.Conclusion.Lemierre’s syndrome may lead to multiorgan dysfunction and should be rapidly identified.

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 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 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 Fusobacterium necrophorum Pharyngitis Complicated by Lemierre’s Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Faraone ◽  
Alberto Fortini ◽  
Gabriele Nenci ◽  
Costanza Boccadori ◽  
Valerio Mangani ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Fusobacterium Necrophorum ◽  
Uneventful Recovery ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
History Of ◽  
Amoxicillin Clavulanic Acid ◽  
Bilateral Lung ◽  
Lemierre's Syndrome

We report the case of an 18-year-old woman who was referred to our outpatient clinic because of a 2-week history of sore throat, high fever, and neck tenderness unresponsive to a 7-day amoxicillin/clavulanic acid course. Infectious mononucleosis was initially suspected, but an extremely high value of procalcitonin and clinical deterioration suggested a bacterial sepsis, prompting the patient admission to our internal medicine ward. Blood cultures were positive for Fusobacterium necrophorum. CT scan detected a parapharyngeal abscess, a right internal jugular vein thrombosis, and multiple bilateral lung abscesses, suggesting the diagnosis of Lemierre’s syndrome. The patient was treated with a 2-week course of metronidazole and meropenem with a gradual clinical recovery. She was thereafter discharged home with metronidazole and amoxicillin/clavulanic acid for 14 days and a 3-month course of enoxaparin, experiencing an uneventful recovery. The present case highlights the importance of taking into consideration the Lemierre’s syndrome whenever a pharyngotonsillitis has a severe and unusual course.

scholarly journals Lemierre’s Syndrome: A Rare Case of Pulmonic Valve Vegetation

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Clara Kwan ◽  
Lou Mastrine ◽  
Manfred Moskovits
Keyword(s):  
Right Ventricular Outflow Tract ◽  
Fusobacterium Nucleatum ◽  
Ventricular Outflow Tract ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Pulmonic Valve ◽  
Vein Thrombosis ◽  
The Right ◽  
Lemierre's Syndrome

Lemierre’s syndrome is an uncommon complication of pharyngitis commonly associated with an anaerobic gram negative bacterium,Fusobacterium necrophorum. The syndrome usually affects young healthy adults with the mean age of 20 and is characterized by recent pharyngitis followed by ipsilateral internal jugular vein thrombosis and septic thromboembolism. The treatment is at least 6 weeks of antibiotics; the role of anticoagulation is unclear. The following presentation is a case of Lemierre’s syndrome in a 23-year-old healthy individual who is infected by a rare species:Fusobacterium nucleatum. The case is complicated by septic emboli to the lungs and impressive seeding vegetation to the right ventricular outflow tract (RVOT) at the pulmonic valve of the heart.

Lemierre’s syndrome: a complication of acute oropharyngitis

2000 ◽  
Vol 114 (7) ◽  
pp. 545-547 ◽  
Author(s):  
R. Agarwal ◽  
P. S. Arunachalam ◽  
D. A. Bosman
Keyword(s):  
Case Report ◽  
Sore Throat ◽  
Cranial Nerve ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Cranial Nerve Palsies ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a recognized but infrequently seen complication of acute oropharyngitis. In this case report the patient presented with acute sore throat that led to a bacteraemia with internal jugular vein thrombosis and subsequent cranial nerve palsies.

scholarly journals Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Samantha Novotny ◽  
Kenneth Serrano ◽  
Danielle Bazer ◽  
Louis Manganas
Keyword(s):  
Cavernous Sinus ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Streptococcus Viridans ◽  
Cavernous Sinus Thrombosis ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

Background. Lemierre’s syndrome is a rare condition of internal jugular vein thrombosis following oropharyngeal infection. While it usually results from Fusobacterium necrophorum infection, atypical cases associated with other pathogens have been reported. Objective. To describe a unique case of pediatric Lemierre’s syndrome with Streptococcus viridans infection resulting in cavernous sinus thrombosis and oculomotor, trochlear, and abducens nerve palsies. Case Report. A 14-year-old female initially presented after six days of fever, myalgias, and sore throat and was admitted for hyperbilirubinemia and acute kidney injury. She developed a fixed, dilated pupil with complete ophthalmoplegia, ptosis, and severe pain. Imaging revealed retromandibular space abscess, external and internal jugular vein thrombosis, cavernous sinus thrombosis, internal carotid artery stenosis, pulmonary embolism, and bilateral pneumonia. She was diagnosed with Lemierre’s syndrome with cultures positive for Streptococcus viridans and treated with a combination of antibiotics and anticoagulation. Conclusion and Relevance. Both antibiotics and anticoagulation were effective management for this Lemierre’s syndrome patient with cavernous sinus thrombosis. Early diagnosis and treatment of Lemierre’s syndrome is essential. A multidisciplinary treatment team is beneficial for managing the sequelae of this condition.

scholarly journals Self-Extubation in the Surgical Intensive Care Unit and Restraint Policy Change: A Retrospective Study

2014 ◽  
Vol 1 (1) ◽  
pp. 10-14 ◽  
Author(s):  
John T. Denny ◽  
Enrique Pantin ◽  
Julia Denny ◽  
William Grubb ◽  
James Tse ◽  
...  
Keyword(s):  
Intensive Care ◽  
Policy Change ◽  
Initial Study ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Face To Face ◽  
Life Threatening ◽  
Recent Policy

Background:Self-extubation is a serious complication of mechanical ventilation. The incidence of self-extubation in a university hospital may be altered by a recent policy change, which requires daily written and face-to-face patient re-evaluations regarding the need for restraints in the intensive care units. There are many concerns and suspicions that this might result in less use of restraints and thereby increase the risk of self-extubation.Methods:The goal of this study was to describe the incidence of self-extubation (SE) over time and report any observed change with the change in restraint policy (RP).Results:The rate of self-extubation during the control year was 1.62% which increased to 2.33% during the initial study period and decreased to 1.30% in the following year. The distant follow-up period eight years after the initial change in restraint policy showed a rate of 1.14%. Apache scores did not differ significantly between the years compared.Conclusion:A new restraint policy, which requires frequent reordering by physicians, has the potential to be associated with increased self-extubation, at least temporarily. Staff education may help reduce this risk. Further research will be useful in clarifying which interventions can most reduce this potentially life-threatening complication.

scholarly journals Unusual case of Lemierre’s syndrome

2018 ◽  
Vol 11 (1) ◽  
pp. e226948 ◽  
Author(s):  
Issrah I Jawad ◽  
Arjun Chandna ◽  
Stephen Morris-Jones ◽  
Sarah Logan
Keyword(s):  
Internal Jugular Vein ◽  
Unusual Case ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Campylobacter Rectus ◽  
Lemierre's Syndrome ◽  
Supportive Management ◽  
Rare Diagnosis

A young previously healthy patient presented with sepsis and cavitating pneumonia. Campylobacter rectus was isolated from blood cultures and subsequent CT neck showed an internal jugular vein thrombosis. Treatment was with antibiotics, anticoagulation and supportive management. Lemierre’s syndrome is an infectious thrombophlebitis of the internal jugular vein. Although a rare diagnosis since the use of penicillin for treatment of acute pharyngitis, it is being reported with increasing frequency. Usually associated with Fusobacterium spp, we believe that this is the first reported case of Lemierre’s caused by C. rectus—an anaerobic member of the human oral cavity flora, usually associated with localised periodontal disease. The bacillus was isolated from blood during the acute presentation.

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.

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