Complicated otitis media caused by Fusobacterium necrophorum

2004 ◽  
Vol 118 (1) ◽  
pp. 50-53 ◽  
Author(s):  
W. Giridharan ◽  
S. De ◽  
E. Z. Osman ◽  
L. Amma ◽  
J. Hughes ◽  
...  
Keyword(s):  
Otitis Media ◽  
Internal Jugular Vein ◽  
High Mortality ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Primary Sources ◽  
Aetiological Agent ◽  
Septic Thrombophlebitis ◽  
Oropharyngeal Infection ◽  
Sources Of Infection

Fusobacterium necrophorum is implicated as an aetiological agent in a variety of necrotic diseases, such as Lemièrre’s syndrome (LS) in humans. LS was initially described as septic thrombophlebitis of the internal jugular vein secondary to an acute oropharyngeal infection. Other primary sources of infection include parotitis, otitis media, sinusitis, odontogenic infection and m stoiditis. In the pre-antibiotic era LS carried a high mortality. This has been reduced as a result of the widespread use of antibiotics, butthere is still a definite morbidity and mortality associated with infection with this virulent organism. We report three cases of complicatedotitis media caused by Fusobacterium necrophorum. The patients were treated successively with intravenous metronidazole and surgery.

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 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 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 Thoracic Complications of Lemierre Syndrome

2000 ◽  
Vol 7 (6) ◽  
pp. 481-485 ◽  
Author(s):  
Russell Thomas Gowan ◽  
Reza John Mehran ◽  
Pierre Cardinal ◽  
Gwynne Jones
Keyword(s):  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Review Of The Literature ◽  
Septic Thrombophlebitis ◽  
Lemierre Syndrome ◽  
Gram Negative ◽  
Negative Bacillus ◽  
Oropharyngeal Infection ◽  
Gram Negative Bacillus ◽  
The Subject

Lemierre syndrome is a severe, septicemic illness most commonly caused by the anaerobic Gram-negative bacillusFusobacterium necrophorum. It is characterized by an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. This report of a patient with the Lemierre syndrome is complemented by a review of the literature on the subject.

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 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.

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.

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