Lemierre's Disease: Postanginal Bacteremia and Pulmonary Involvement Caused by Fusobacterium necrophorum

Moreno, Santiago; Altozano, J. García; Pinilla, Blanca; López, Juan Carlos Cortés; Quirós, Bemaldo de; Ortega, Antonio Martínez; Bouza, Emilio

doi:10.1093/clinids/11.2.319

Cited by 147 publications

(101 citation statements)

References 22 publications

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“…This infection spreads to the carotid sheath which in turn results in internal jugular vein thrombosis. This infection spreads hematogenously, producing septic emboli most commonly in the lungs [2,3]. The lung involvement was reported by Senave et al in 97% of the cases [2].…”

Section: Discussionmentioning

confidence: 99%

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Uncommon Association of Pulmonary Infiltrates

Kumar¹,

Radhan²,

Dev³

2015

J Pulm Respir Med

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A 24 year old male patient presented with fever, chills, sore throat and neck pain since 2 weeks. He was tachycardiac and tachypneic on arrival. On auscultation, decreased entry in both lower lobes and crepitations were noted. Laboratory investigations showed elevated C-Reactive protein (CRP) and increased white blood cells (WBC) counts of 14,200/cm 3 . Chest radiograph supine AP view (Figure 1) was done initially on admission. As the patient's condition worsened, a Computed Tomography (CT) scan of neck and chest (Figures 2-4) with intravenous contrast medium was done.

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Section: Discussionmentioning

confidence: 99%

“…The lung involvement was reported by Senave et al in 97% of the cases [2]. It may also cause meningitis [2], epidural abscess [2], septic arthritis [2], hepatic abscesses [3], splenic abscesses [3] and osteomyelitis [3]. The patient may present either with neck symptoms or pulmonary symptoms or both.…”

Section: Discussionmentioning

confidence: 99%

Uncommon Association of Pulmonary Infiltrates

Kumar¹,

Radhan²,

Dev³

2015

J Pulm Respir Med

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“…Because of the rarity of Lemierre syndrome, the antibiotic choice is based on anecdotal clinical evidence. With cases of reported penicillin resistance, 16,17 most authors recommend the use of a penicillin/β-lactamase inhibitor combination. Metronidazole may be another alternative, especially in cases of penicillin allergies.…”

Section: Discussionmentioning

confidence: 99%

Lemierre Syndrome: Not So Forgotten!

Gupta

Kralovic

McGraw

2014

American Journal of Critical Care

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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.

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“…The absence of controlled studies is explained by the rarity of the disease [15]. Current recommendation is based on consensus opinions, many experts advising against anticoagulation for non-extensive IJV thrombosis [12]. However, it was determined that, despite the non-extensive nature of the IJV thrombus in this case, the risks-benefit analysis favored anticoagulation as the disease was still evolving, with significant potential for thrombus extension and the propagation of embolic events.…”

Section: Discussionmentioning

confidence: 99%

“…Septic embolus to the lung is the most common embolic complication occurring in over 95% of cases [11]. Moreno and Altozano in Madrid reviewed cases of Lemierre's syndrome with pulmonary septic emboli [12]. They report that features relatable to assault on the lungs usually manifest early (even on the first day of the septicemia); symptoms include cough (unusual for streptococcal pharyngitis), pleuritic chest pain and hemoptysis [9].…”

Section: Introductionmentioning

confidence: 99%

Lemierre Syndrome Complicating Pharyngotonsilitis in a Young Male: A Case Report

Adeoye

2013

J Med Cases

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Lemierre syndrome is a very rare complication of head and neck infections. We present a case report on a healthy young male who developed unremitting fever, marked leucocytosis, multiple pulmonary consolidation, and internal jugular vein thrombosis in the setting of a pharyngotonsilitis. The atypicality of the presentation is emphasized, diagnostic and therapeutic considerations and complications are discussed. This report makes the case for entertaining a diagnosis of Lemierre' syndrome complicating antecedent head and neck space infection especially when presentation is atypical or response to conventional care is suboptimal.

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Lemierre's Disease: Postanginal Bacteremia and Pulmonary Involvement Caused by Fusobacterium necrophorum

Cited by 147 publications

References 22 publications

Uncommon Association of Pulmonary Infiltrates

Uncommon Association of Pulmonary Infiltrates

Lemierre Syndrome: Not So Forgotten!

Lemierre Syndrome Complicating Pharyngotonsilitis in a Young Male: A Case Report

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