A case of Lemierre syndrome combined with a suspected systemic lupus erythematosus flare

Abstract

Lemierre syndrome develops in healthy young patients as a result of bacteremia after oral cavity infection. It causes thrombophlebitis in the internal jugular vein. Infection can easily occur during immunosuppressive treatment in patients with systemic lupus erythematosus and become severe. We present a case of Lemierre syndrome in a patient with systemic lupus erythematosus. A 56-year-old woman presented with fever, left lower toothache, and skin symptoms from the left neck to the anterior chest. Clinical presentation and laboratory investigations revealed Lemierre syndrome. The inflammation and thrombus disappeared with antibiotic and anticoagulant therapies. However, transient hypocomplementemia and elevated antinuclear antibody levels were observed during treatment; therefore, a concomitant systemic lupus erythematosus flare was considered. In systemic lupus erythematosus patients with Lemierre syndrome, complement and antinuclear antibody levels are modified, so other indicators should be precisely evaluated, such as levels of urinary protein, sediment, serum creatinine and anti-dsDNA antibody, and systemic lupus erythematosus disease activity index.

Lemierre Syndrome in a Pediatric Patient with Nephrotic Syndrome: A Case Report

“…There are several published case studies over the past years that report cases of LS in previously healthy individuals and associated thrombosis in different sites, including lungs, bones, and brain. Also, LS was described in patients with different medical conditions including systemic lupus erythematosus, different types of arthritis among others (7,8). The emergency physician should have a low threshold for LS in any patient with such conditions presenting with neck pain, sore throat, fever, or high inflammatory markers to the emergency department.…”

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

“…Lemierre's syndrome (LS) is an uncommon, lifethreatening disease with an incidence rate of 0.6 to 2.3 cases per million people and a mortality rate of 4% -22% (1). It is a septic thrombophlebitis of the internal jugular vein (IJV) paralleled with embolic abscesses, which develops as a severe complication of oropharyngeal infection (2). However, this syndrome has also been reported during anaerobic septicemia, originating from diverse sources of infection, such as the gastrointestinal system or the genitourinary tract (3).…”