scholarly journals Fusobacterium necrophorum subsp. necrophorum Liver Abscess with Pylephlebitis: An Abdominal Variant of Lemierre’s Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Natasa Radovanovic ◽  
Igor Dumic ◽  
Mladjen Veselinovic ◽  
Susanne Burger ◽  
Tamara Milovanovic ◽  
...  
Keyword(s):  
Portal Vein ◽  
Liver Abscess ◽  
Treatment Strategy ◽  
Clinical Presentation ◽  
Fusobacterium Necrophorum ◽  
Significant Morbidity ◽  
Lemierre’S Syndrome ◽  
Vein Thrombosis ◽  
Source Of Infection ◽  
Lemierre's Syndrome

Liver abscess associated with suppurative portal vein thrombosis (pylephlebitis) secondary to Fusobacterium necrophorum has been rarely reported. It is considered to be an abdominal variant of Lemierre’s syndrome associated with significant morbidity and mortality. We report a case of 69-year-old man who developed liver abscess and pylephlebitis due to F. necrophorum with an unclear source of infection. We discuss the pathogenesis, diagnosis, and treatment strategy for this entity, with a review of previously published cases of pyelephlebitis due to F. necrophorum in regard to their clinical presentation and outcome.

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 An Unusual Variant of Lemierre’s Syndrome with Multiple Abscesses and Hepatic Vein Thrombosis

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Abrakhom Zeyni ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatic Vein ◽  
Abdominal Ultrasound ◽  
Fusobacterium Necrophorum ◽  
Watery Diarrhea ◽  
Lemierre’S Syndrome ◽  
Vein Thrombosis ◽  
Hepatic Vein Thrombosis ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Introduction: Lemierre’s syndrome is an uncommon, life-threatening disease that develops as a severe complication of oropharyngeal infection. However, this syndrome has also been reported during anaerobic septicemia, originating from diverse sources of infection, such as the gastrointestinal system. The diagnosis of this syndrome remains challenging, and is often prompted by the detection of Fusobacterium necrophorum in blood culture, rather than with clinical signs or symptoms. Case Presentation: A previously healthy 38-year-old woman was hospitalized for a 6-day history of fever, watery diarrhea, and vomiting. Physical examination of the patient showed fever, pharyngitis, and diffuse abdominal tenderness. Laboratory investigations revealed elevated inflammatory markers, and two blood cultures revealed Fusobacterium necrophorum. An abdominal ultrasound showed a liver abscess and hepatic vein thrombosis. The thoracoabdominal and cerebral computed tomography scan confirmed the results of the abdominal ultrasound. It additionally revealed bilateral lung nodules and a parietal brain abscess. The patient’s general condition and her laboratory test results, improved after receiving treatment with ceftriaxone and metronidazole. She received antibiotics for three months, without anticoagulation therapy. Repeated computed tomography scans showed a resolution of the liver, pulmonary, and brain abscesses, as well as the recanalization of the hepatic vein. Conclusions: Lemierre’s syndrome emerges as a result of septic illness and liver abscesses in case of gastrointestinal symptoms despite the lack of common presentation.

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 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 Lemierre’s Syndrome Due to Methicillin-Resistant Staphylococcus aureus

2019 ◽  
Vol 7 ◽  
pp. 232470961989096
Author(s):  
Rolando A. Zamora Gonzalez ◽  
Juan C. Sarria ◽  
Nicole A. Christians ◽  
Michelle Baliss
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Methicillin Resistant ◽  
Septic Emboli ◽  
Vein Thrombosis ◽  
Etiologic Agents ◽  
Appropriate Treatment ◽  
Lemierre's Syndrome

Lemierre’s syndrome is an uncommon and potentially fatal complication of oropharyngeal and facial infections. It involves an associated septic thrombophlebitis, bacteremia, and septic emboli. Traditionally, compromise of the internal jugular vein has been described in conjunction with an infection caused by anaerobes, especially, Fusobacterium necrophorum. In recent years, however, variant forms have been appearing, including other vessel compromise and other etiologic agents. We present the case of Lemierre’s syndrome in a 31-year-old male with facial vein thrombosis, septic emboli to the lungs, and bacteremia caused by methicillin-resistant Staphylococcus aureus. We hope that this case will raise awareness about variant presentations and promote a timely diagnosis and appropriate treatment of this potentially fatal infection.

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.

scholarly journals A case of Fusobacterium necrophorum sepsis (Lemierre's syndrome) with pulmonary septic emboli and liver abscess

2011 ◽  
Vol 34 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Eiji YAMAMOTO ◽  
Tomoaki FUKAE ◽  
Yasufumi KAWAI ◽  
Manabu KAMIO ◽  
Hideki HONDA ◽  
...  
Keyword(s):  
Liver Abscess ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Septic Emboli ◽  
Lemierre's Syndrome

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.

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