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.

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 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.

scholarly journals Lemierre Syndrome: Two Preschool Children with Cerebral Infarcts

2008 ◽  
Vol 1 ◽  
pp. CMPed.S879
Author(s):  
Miriam Santschi ◽  
Michèle David ◽  
Laurent Garel ◽  
Michel Vanasse ◽  
France Gauvin
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Left Internal Jugular Vein ◽  
Cerebral Infarcts ◽  
Jugular Vein Thrombosis ◽  
Lemierre Syndrome ◽  
Vein Thrombosis ◽  
First Case ◽  
One Year

We report two children who developed hemiparesis secondary to cerebral infarcts complicating Lemierre syndrome. The first case is a one-year-old patient who presented a left internal jugular vein thrombosis and a left carotid compression due to retropharyngeal cellulitis. The second case is a five-year-old girl who presented a left internal jugular vein and a right carotid artery thrombosis associated with an oropharyngeal cellulitis. Etiologic agents involved were Staphylococus aureus in the first case and Fusobacterium necrophorum in the second case. These cases call for vigilance among physicians for this rare syndrome, its unusual presentation and its associated severe complications.

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 A Rare Case Report of Lemierre Syndrome from the Anterior Jugular Vein

2020 ◽  
Vol 4 (3) ◽  
pp. 454-457
Author(s):  
Nima Rejali ◽  
Marissa Heyer ◽  
Doug Finefrock
Keyword(s):  
Case Report ◽  
Internal Jugular Vein ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Jugular Vein ◽  
Anticoagulation Therapy ◽  
Fusobacterium Necrophorum ◽  
Lemierre Syndrome ◽  
Septic Emboli ◽  
Radiologic Findings

Introduction: Lemierre syndrome is a rare, potentially fatal, septic thrombophlebitis of the internal jugular vein. Treatment includes intravenous antibiotics for Fusobacterium necrophorum, the most common pathogen, as well as consideration for anticoagulation therapy. Case Report: A 27-year-old female presented with left-sided neck swelling and erythema. Computed tomography noted left anterior jugular vein thrombophlebitis and multiple cavitating foci, consistent with septic emboli. We report a rare case of Lemierre syndrome in which the thrombus was found in the anterior jugular vein, as opposed to the much larger internal jugular vein more traditionally associated with creating septic emboli. Conclusion: Based on an individual’s clinical symptoms, history, and radiologic findings, it is important for physicians to consider Lemierre syndrome in the differential diagnosis, as the condition may rapidly progress to septic shock and death if not treated promptly. The use of anticoagulation therapy remains controversial, and there is a lack of established standard care because the syndrome is so rare.

Internal jugular vein ectasia – a rare cause for paroxysmal cough

2006 ◽  
Vol 121 (8) ◽  
pp. 742-744 ◽  
Author(s):  
K Padmanabhan ◽  
B Vaishali ◽  
R Indudharan
Keyword(s):  
Computed Tomography ◽  
Vagus Nerve ◽  
Internal Jugular Vein ◽  
Ultrasound Imaging ◽  
Jugular Vein ◽  
Rare Clinical Entity ◽  
Neck Swelling ◽  
Computed Tomography Scan ◽  
Valsalva's Manoeuvre ◽  
Tomography Scan

AbstractInternal jugular vein ectasia (dilatation of the internal jugular vein) is a rare clinical entity, often undiagnosed. Usually it presents as an asymptomatic, soft, compressible neck swelling that increases in size on Valsalva's manoeuvre. Our report describes right internal jugular vein ectasia in a 15-year-old girl who presented to us with intractable paroxysmal cough. The entity was suspected on ultrasound imaging and confirmed by computed tomography scan and Doppler. Ligation and excision of the dilated vein almost immediately cured her cough. The probable reason for the cough was the pressure exerted by the dilated vein on the vagus nerve.

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.

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.

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