Bilateral abducens nerve palsy due to septic thrombophlebitis

Vu, Vincent N.; Savino, Peter J.; Robbins, Shira L.

doi:10.1016/j.ajoc.2019.100566

Cited by 5 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is the most clinically relevant bacterium in any discussion of LS. Though F. necrophorum is the most common cause of LS, it is important to note that Gram-positive cocci have caused LS as well [5,9].…”

Section: Microbiologymentioning

confidence: 99%

“…Pathogenesis occurs from the entry of the causal organism through the oropharyngeal mucosa from trauma, inflammation, or tissue destruction [8]. After passing through the mucosal barrier, post-anginal sepsis can develop as the organism directly spreads from an abscess through the deeper loose connective cervical tissues, spreads via hematogenous mechanisms, or spreads via a lymphogenic mechanism in order to extend into the veins of the head or neck with the most frequent route being from the tonsil into the ipsilateral internal jugular vein [1,[9][10]. Regardless of which path the bacteria takes and which vein it is able to seed within, the pathogenic organism will eventually activate platelets, activate the coagulation cascade, and cause inflammation leading to thrombus formation and LS disease progression.…”

Section: Pathophysiologymentioning

confidence: 99%

“…LS can also present with uncommon symptoms and ocular involvement is a particularly rare manifestation of LS [7,9,13]. Based on our comprehensive literature review, we could only identify 27 total patients between 2009 and 2019 that met our criteria for LS and who presented with any symptom involving the orbit, the extraocular muscles, the optic nerve, the oculomotor nerve, the trochlear nerve, the abducens nerve, or the cavernous sinus.…”

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

“…To understand the scope of ophthalmologic complications in LS, we performed a literature search which is outlined in Table 1. Recently, Vu et al performed a literature search in 2019 where they could only identify four cases of LS where diplopia was reported [9]. Our subsequent literature search showed nine reported cases of LS where diplopia was specifically used to describe a patient symptom ( Table 1).…”

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

“…In LS, when individual cranial nerves are affected, isolated palsies of the abducens nerve and trochlear nerve are most commonly involved [10]. When ocular motility is affected, the most common defect is due to an abducens nerve palsy [9]. Taken together, this would imply that the abducens nerve is relatively more susceptible to the retrograde spread of septic emboli in LS relative to the other neurovascular structures of the orbit and eye.…”

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review of Lemierre’s Syndrome With a Focus on Ophthalmologic Complications

Dasari¹,

Jha²

2020

Cureus

View full text Add to dashboard Cite

Lemierre's syndrome (LS), once known as "the forgotten disease," is a rare and potentially lifethreatening condition that has had a gain in incidence over the last 30 years due to a variety of factors that could include changes in antibody prescription patterns, particularly in regard to the treatment of pharyngitis/tonsillitis. Due to its low incidence and broad spectrum of symptoms, LS does not have an obvious clinical diagnosis and can confuse the clinician managing the patient. Furthermore, it is equally difficult to treat patients suffering from LS as it requires a multidisciplinary approach from multiple subspecialties. Thus, communication between hospitalists, radiologists, otolaryngologists, neurologists, and ophthalmologists is critical towards quickly diagnosing the disease condition so that prompt antibiotics, anticoagulation, and surgical intervention can occur. Atypical presentations can also exist, making the diagnosis and management exponentially more challenging. Ophthalmologic symptoms are a particularly rare and atypical presentation of LS. These rare symptoms in LS can be terrifying for patients and providers alike; yet, there does not seem to be any modern medical literature that summarizes ophthalmologic complications for LS patients. To our knowledge, this is the first systematic review of LS with a focus on ophthalmologic complications that has been done. The main objective of this review paper is to provide an up-to-date literature review of LS epidemiology, pathophysiology, diagnosis, and treatment while also performing a novel systematic review of reported cases of LS with ophthalmological complications. We hope to bring more awareness towards LS and its atypical presentations so that physicians will be better able to rapidly diagnose and treat their patients in order to minimize long-term morbidity and mortality.

show abstract

Section: Microbiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

Section: Systematic Review Of Ophthalmologic Complicationsmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Lemierre’s Syndrome With a Focus on Ophthalmologic Complications

Dasari¹,

Jha²

2020

Cureus

View full text Add to dashboard Cite

show abstract

Prismen zur Blickverlagerung und Schielkorrektur bei Augenmotilitätsstörungen und Kopfzwangshaltung

Eppenberger

DiTaranto

Bücheler

et al. 2021

Klin Monbl Augenheilkd

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Das therapeutische Management von Motilitätseinschränkungen und begleitender Kopfzwangshaltung (KZH) stellt oft eine Herausforderung dar. Wir berichten über unsere Erfahrungen mit der Prismenapplikation. Patienten und Methoden Retrospektive Fallserie von 3 Patienten mit Augenmotilitätsstörungen und begleitender KZH, bei denen eine Behandlung mittels Prismenkorrektur erfolgte. Ergebnisse Ein 37-jähriger Mann mit traumatischer Okulomotoriusparese links mit leichter residueller Senkungseinschränkung und deutlicher Hebungseinschränkung zeigte nach Prismenausgleich der Hypotropie links (OS: 10^ Basis oben) ein Feld binokularen Einfachsehens (BES-Feld) nur im Abblick. Erst unter zusätzlicher Vorgabe von beidseits 10^ Basis oben gelang eine Verlagerung des BES-Feldes in die Primärposition. Ein 45-jähriger Mann mit Parinaud-Syndrom infolge eines Schädel-Hirn-Traumas und beidseitiger Hebungseinschränkung beklagte erhebliche Nackenbeschwerden bei ausgeprägter Kinnhebung. Zudem bestand bei Amaurose rechts eine sekundäre Exotropie. Unter Vorgabe von OS: 8^ Basis oben war der Patient bei Aufgabe der KZH auch subjektiv beschwerdefrei. Bei einer 69-jährigen Frau mit Abduzensparese links bestand eine Kompensation der Schielabweichung nur im äußersten Rechtsblick unter Einnahme einer ausgeprägten Linksdrehung von 20°. Mit OS: 20^ Basis temporal resultierte Doppelbildfreiheit ohne KZH in Primärposition. Schlussfolgerung Neben der Schielkorrektur kann auch die Blickverlagerung durch Prismen in verschiedenen klinischen Konstellationen therapeutisch hilfreich sein. Zur Reduktion der KZH erfolgt die prismeninduzierte Blickverlagerung prinzipiell in Richtung des Motilitätsdefizits.

show abstract

Lemierre Syndrome: Unusual Presentation With Superior Ophthalmic Vein Thrombosis

Caruso

2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Lemierre syndrome (LS) is a rare, but serious condition most commonly associated with oropharyngeal bacterial infection. Infection results in thrombophlebitis of the internal jugular vein and its tributaries. It usually affects previously healthy young adults. The authors report an unusual case of an elderly patient with penicillin allergy who developed Lemierre syndrome from an odontogenic infection (Streptococcus intermedius) resistant to clindamycin. She developed thrombosis of the internal jugular vein and superior ophthalmic vein resulting in visual changes. Treatment required incision and drainage, intravenous antibiotics and anticoagulation. Antibiotics were tailored to culture and sensitivities after testing response to a beta-lactam. With antibiotic resistance increasing, investigation of penicillin allergies is warranted for severe head and neck infections.

show abstract

Bilateral abducens nerve palsy due to septic thrombophlebitis

Cited by 5 publications

References 9 publications

A Systematic Review of Lemierre’s Syndrome With a Focus on Ophthalmologic Complications

A Systematic Review of Lemierre’s Syndrome With a Focus on Ophthalmologic Complications

Prismen zur Blickverlagerung und Schielkorrektur bei Augenmotilitätsstörungen und Kopfzwangshaltung

Lemierre Syndrome: Unusual Presentation With Superior Ophthalmic Vein Thrombosis

Contact Info

Product

Resources

About