Lemierre's syndrome: A systematic review

Abstract

Lemierre's syndrome may not be as rare as previously thought. This apparent increase in the incidence may be due to antibiotic resistance or changes in antibiotic prescription patterns. Successful management rests on the awareness of the condition, a high index of suspicion, and a multidisciplinary team approach.

Lemierre's syndrome presented with acute pancreatitis

“…Other sources include upper and lower respiratory, mastoiditis, laryngitis, dental, paranasal sinusitis, parotitis, orbital, gastrointestinal, and lip piercing 2. These infections invade to the carotid sheath and cause IJV septic thrombophlebitis within 1–3 weeks 7, 8.…”

“…The IJV thrombophlebitis presents as unilateral cervical tenderness that mimics lymphadenopathy. Metastatic septic emboli are common in lung (85%) and large joints (16–26%) 2, 3. Other metastatic diseases include soft tissue abscess, cutaneous lesions, pyomyositis, splenic and liver abscess, osteomyelitis, endocarditis, pericarditis, renal abscess, hemolytic uremic syndrome, and central nervous system complications including encephalopathy, meningitis, cerebral infarctions, epidural abscess, and brain abscess 3, 7, 8.…”

“…Next, there is invasion of the lateral pharyngeal wall and thrombophlebitis of the internal jugular vein. This is then followed by bacteremia and septic emboli to vital organs, which can lead to metastatic abscesses, as well as other fatal complications 2, 3, 4…”

“…In this modern era, the incidence is approximately 0.6–3.2 persons per million per year 2, 3, 6. It is most common in young adults aged between 15 and 24 years 2.…”

Some neck swellings are serious; a case of Lemierre’s Syndrome

“…There was not a single case reported between 1950’s and 1960’s but has been more overlooked than forgotten in recent years. According to a systematic review by Karkos et al [2]., its incidence has been steadily increasing since the 1980’s, there were six online reported cases from 1980–1990 which rose to 121 from 2000 to 2008. It may be due to the emergence of resistant strains of causative pathogens, more emphasis on the judicious use of antibiotics or simply less clinical suspicion in the minds of physicians.…”