Internal Jugular Vein Thrombosis, Lemierre's Syndrome; Oropharyngeal Infection with Antibiotic and Anticoagulation Therapy

Angiology ◽  
2000 ◽  
Vol 51 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Shin Nakamura ◽  
Seizo Sadoshima ◽  
Yasufumi Doi ◽  
Maki Yoshioka ◽  
Shigeru Yamashita ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Anticoagulation Therapy ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Oropharyngeal Infection ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

scholarly journals Jugular vein thrombosis and anticoagulation therapy in Lemierre’s syndrome – a post-hoc observational and population-based study of 82 patients

2020 ◽  
Author(s):  
David Nygren ◽  
Johan Elf ◽  
Gustav Torisson ◽  
Karin Holm
Keyword(s):  
Jugular Vein ◽  
Anticoagulation Therapy ◽  
Population Based ◽  
Invasive Infection ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Septic Complications ◽  
Vein Thrombosis ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Abstract Background Lemierre’s syndrome is typically caused by Fusobacterium necrophorum where an oropharyngeal infection is followed by septic internal jugular vein thrombophlebitis with subsequent septic embolization. Yet, the pathogenesis of septic thrombophlebitis, differences dependent on presence of jugular vein thrombosis and the role of anticoagulant therapy are insufficiently understood. Methods Patients with invasive infection with F. necrophorum and Lemierre’s syndrome who had been investigated for jugular vein thrombosis were included from a previous population-based observational study in Sweden. Medical records were reviewed and compared in patients with and without jugular vein thrombosis. Then, patients with jugular vein thrombosis were compared by exposure to therapeutic, prophylactic or no anticoagulation. Outcomes examined were thrombosis progression, early or late peripheral septic complications, chronic major sequelae, 30-day mortality and major bleeding. Results 51/82 (62%) radiologically investigated patients with Lemierre’s syndrome had jugular vein thrombosis. Patients with jugular vein thrombosis had lower platelet levels (median 76 vs 112 x10^9/L, p=0.04) on presentation and more days to defervesence (12 vs. 7 days, p=0.03), yet similar rates of major sequelae and 30-day-mortality. No significant differences in outcomes were seen between patients with jugular vein thrombosis exposed to therapeutic, prophylactic or no anticoagulation therapy, yet study outcomes were rare. Conclusion Patients with Lemierre’s syndrome with jugular vein thrombosis were more severely affected, yet had similar prognosis. Most patients with jugular vein thrombosis recovered well without therapeutic anticoagulation therapy, though adverse events were similarly rare in anticoagulated patients. The observational design and rarity of study outcomes requires cautious interpretation.

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 Lemierre's Syndrome: A Case of a Large Inflammatory Neck Mass with Internal Jugular Vein Thrombosis and Literature Review of Its Surgical Intervention

2021 ◽  
Author(s):  
Yilin Shen ◽  
Bin Ye ◽  
Qian Da ◽  
Chaofu Wang ◽  
Mingliang Xiang
Keyword(s):  
Surgical Treatment ◽  
Internal Jugular Vein ◽  
Surgical Intervention ◽  
Jugular Vein ◽  
Neck Mass ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

Abstract Background: Lemierre's syndrome is a fatal and rare disease that is typically characterized by oropharyngeal infection and internal jugular vein thrombosis. Timely application of appropriate antibiotics is the standard treatment. However, when conservative medical treatment fails to have effect, surgical intervention may be the only effective option for controlling the source of infection. Case presentation: The authors report a case of Lemierre's syndrome with a large inflammatory neck mass involving left internal jugular vein thrombosis that was cured by surgical treatment. In addition, a literature review was carried out through PubMed using the terms “Lemierre’s syndrome/disease and review, meta-analysis or retrospective study” and “Lemierre’s syndrome/disease and internal jugular vein”. This search yielded 6 articles that recorded the surgical rate in detail. Conclusion: The purpose of this review was to summarize the conditions under which surgical treatment are conducted. Additionally, this is the first report of such a large inflammatory neck mass that was completely cured by surgical resection and internal jugular vein ligation. The authors further offer several conclusions regarding surgical intervention in Lemierre’s syndrome.

Lemierre’s Syndrome: Unusual Cause of Internal Jugular Vein Thrombosis

Angiology ◽  
2005 ◽  
Vol 56 (4) ◽  
pp. 483-487 ◽  
Author(s):  
Seung Kee Min ◽  
Yeon Ho Park ◽  
Yong Kyun Cho ◽  
Jeong Woong Park ◽  
Young Hwan Koh ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Internal Jugular Vein Thrombosis ◽  
Lemierre's Syndrome

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.

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.

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