Eponym

Abstract

Fig. 1 Dr. Andre Lemierre Lemierre syndrome, also known as postanginal sepsis, is a severe complication of an acute oropharyngeal infection that results in septic thrombophlebitis of the ipsilateral internal jugular vein with subsequent septicemia, often complicated by metastatic infections. The usual agent in Lemierre syndrome is Fusobacterium necrophorum, a commensal bacillus of the oral cavity. After the advent of antibiotic therapy, especially in the 1960s and 1970s, when penicillin was frequently used to treat pharyngeal infections, Lemierre syndrome was often referred to as the "forgotten disease". Today with increasing antibiotic-resistant organisms and decreasing awareness of the syndrome, subsequent reemergence of this syndrome is becoming more common in clinical settings. The syndrome starts initially as an acute oropharyngeal infection followed by septicemia with intense fevers, rigors, swelling, and tenderness on the lateral aspect of the neck, parallel to the sternomastoid muscle (septic internal jugular vein thrombophlebitis), and multiple metastatic infections.

Porphyromonas asaccharolytica as a Rare Causative Agent for Lemierre’s Syndrome

“…The most common microorganism associated with Lemierre's syndrome is Fusobacterium necrophorum [ 2 ]. Analysis of published cases from 1970 to 2007 done by Riordan showed that 86% of the total cases of Lemierre's syndrome had shown growth of F. necrophorum or another Fusobacterium sp.…”

“…Lemierre's syndrome is described as an acute oropharyngeal infection with secondary thrombophlebitis of the internal jugular vein leading to sepsis and metastatic infections [ 1 ]. It is also known by the terms such as “postanginal septicemia” and “necrobacillosis” [ 2 ]. This entity was much more common in preantibiotic era and was associated with a rapidly fatal disease course [ 3 ].…”

“…In most of the case series described for Lemierre's syndrome, males are more commonly affected as compared to females [ 3 ]. Causative organisms are usually oropharyngeal flora, most commonly being the anaerobe Fusobacterium necrophorum [ 2 ]. Porphyromonas asaccharolytica is a rare cause of Lemierre's syndrome with only a few cases being reported in the literature [ 5 – 7 ].…”

Management of a young female patient with Fournier’s gangrene and Lemierre’s syndrome

“…Lemierre's syndrome's incidence is between 0.6 and 2.3 per million. Despite modern antibiotic availability, mortality rates are between 4% and 18%[ 8 ]. Fusobacterium necrophorum is the most common pathogen reported, but several other microorganisms have been also implicated alone or in combination with Fusobacterium necrophorum , including Bacteroides species , groups B and C streptococci, Streptococcus oralis, Fusobacterium nucleatum, Streptococcus intermedious, Staphylococcus epidermidis, Enterococcus species, Proteus mirabilis and Arcanobacterium haemolyticum [ 9 ].…”