Lemierre's syndrome: Acute oropharyngeal infection leading to septic thrombophlebitis of the internal jugular vein with pulmonary septic emboli

Hansberry, David R.; D’Angelo, Michael; Prabhu, Arpan V.; White, Michaela M.; Tilwa, Shiv; Li, Zhengteng; Cox, Mougnyan; Agarwal, Nitin; Kandula, Vinay

doi:10.1016/j.inat.2019.100573

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Use of anticoagulants is still debatable, as no specific guidelines on treating LS are present. 10,11 Many recent cases reported in pediatric population have used some form of anticoagulants, [12][13][14] which seemed to have reduced or slowed the progression of thrombosis. The use of anticoagulants is still questionable though, as there is lack of evidence.…”

Section: Discussionmentioning

confidence: 99%

Lemierre’s syndrome in a child

Hemani

Anjum²,

Akhtar³

et al. 2021

Pak J Med Sci

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Lemierre’s Syndrome (LS) is a rare syndrome most frequently due to an anaerobic organism, Fusobacterium Necrophorum. It is commonly a complication of an acute oropharyngeal infection, but there are exceptions to its presentations. In our case the cause of LS was otitis media caused by Streptococcus species. This is a rather unusual presentation of LS. LS is caused due to septic complications of oropharyngeal infections, which lead to thrombophlebitis of internal jugular vein leading to thrombosis formation. In this case report, we present a case of Lemierre’s syndrome in a seven-year-old male child. The patient presented with high grade fever spikes and earache, which were unresponsive to oral antibiotics. LS was diagnosed in this patient on the basis of clinical, microbiological and radiological findings. After the diagnosis, treatment involved using broad spectrum antibiotics and anticoagulants, followed by surgery. Though role of anticoagulants is controversial in LS, but there is no specific guideline contraindicating the use of anti-coagulants. In our case, timely diagnosis and management enabled us to discharge the patient without any symptoms. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773 How to cite this:Hemani F, Naveed A, Akhtar S, Shahid S. Lemierre’s syndrome in a child. Pak J Med Sci. 2022;38(2):433-435. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Lemierre’s syndrome in a child

Hemani

Anjum²,

Akhtar³

et al. 2021

Pak J Med Sci

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“…26 In our case, as well as in the reviewed literature cases involving the EJV, the presenting symptoms were sore throat and fever. 3,4,7,8,12,14,18,21,27 These symptoms, usually indicate involvement of the peri(tonsillar) area. As for the side involving thrombophlebitis of the EJV, the left side was more often involved.…”

Section: Presenting Symptomsmentioning

confidence: 99%

“…In our review, there were 16 patients (61%) in their 2 nd and 3 rd decades of life. [4][5][6][7][8][9][10][11][12][13][14][15] A review by Karkos et al revealed 51% incidence rate in the 2 nd decade. 16 Although this is mainly a young age group disease, in our review, LS was also found to be present in the 5 th to 8 th decades of life.…”

Section: Age and Incidencementioning

confidence: 99%

Pediatric Patient with Lemierre Syndrome of the External Jugular Vein: Case Report and Literature Review

Schwarz

Habashi

Rosenfeld-Yehoshua

et al. 2021

Int Arch Otorhinolaryngol

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Introduction Lemierre syndrome (LS) involving the external jugular vein (EJV) is rare, and only a few cases have been reported in the literature. Objectives To report a case of LS involving the external jugular vein as well as to make a review of the literature regarding both diagnosis and management strategies. Data Synthesis We describe a case of LS involving the EJV and review the literature of previously published articles to search for additional cases. A PubMed, Embase, Scopus, and Web of science-based search was performed to determine the scope of coverage in well-reported articles in English. Twenty-one papers were retrieved and documented for age, incidence, pathogen, presenting symptoms, imaging, treatment, and outcome, which were noted for each of these cases. In our literature review of 21 papers, there were 16 patients (61%) in their 2nd and 3rd decades of life. Lemierre syndrome was shown to affect females and males equally. The presenting symptoms were a sore throat and fever. Treatment requires intravenous antibiotics, and there is no consensus regarding treatment with anticoagulation. Conclusions The present case report and review of the literature emphasize the importance of history taking as well as physical examination in what seems to be a case of simple tonsillitis.

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