Lemierre’s syndrome: Case report and brief literature review

Zhao, Andrew; Samannodi, Mohammed; Tahir, Muhammad; Bensman, Sarah; Hocko, Michael

doi:10.1016/j.idcr.2017.07.009

Cited by 10 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We presented the case of a young adult with internal jugular thrombosis that developed after untreated pharyngeal infection, which is referred to as Lemierre’s syndrome. This syndrome is classically caused by Fusobacterium necrophorum, a gram-negative obligate anaerobic bacteria [ 5 ]. Lemierre’s syndrome is often referred to as a “forgotten disease” since the widespread antibiotic use in modern clinical practice led to a dramatic decrease in its incidence.…”

Section: Discussionmentioning

confidence: 99%

Lemierre’s Syndrome: A Case of Life-Threatening Infection From Family Medicine Practice

Gohal¹,

Alsubhi²,

Alharbi³

et al. 2021

Cureus

View full text Add to dashboard Cite

The use of antibiotic therapy has led to a major transformation in medicine with a substantial reduction in mortality. Due to the adverse effects associated with inappropriate antibiotic use, antibiotic stewardship interventions have been promoted to improve antibiotic prescription. However, delayed antibiotic therapy, when clinically needed, may result in increased morbidity. Here, we report the case of a previously healthy young man with an untreated acute upper respiratory infection for two weeks, who presented with headache and fever. Physical examination suggested meningitis as evident by neck stiffness and positive Kernig sign. Purulent tonsilitis was also noted. Laboratory findings showed leukocytosis and elevated inflammatory markers. The patient underwent a computed tomography scan to rule out space-occupying lesions prior to lumbar puncture. The scan revealed thrombophlebitis of the left internal jugular vein that extended to the dural venous sinuses. Magnetic resonance imaging confirmed the intracranial dissemination of the disease. Such findings conferred the diagnosis of Lemierre’s syndrome. The patient was admitted to the intensive care unit where he received systemic anticoagulation and prolonged intravenous antibiotics. He developed a good response and was discharged with no residual deficits after six weeks of hospitalization. Lemierre’s syndrome is a serious infection that develops after a pharyngeal infection. Considering the high mortality rate of untreated Lemierre’s syndrome, physicians should keep a high index of suspicion for this condition when they encounter a patient with upper respiratory tract infection with clinical or radiological findings consistent with internal jugular thrombophlebitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Lemierre’s Syndrome: A Case of Life-Threatening Infection From Family Medicine Practice

Gohal¹,

Alsubhi²,

Alharbi³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…[10] Another explanation is the fact that antibiotic prescription practices have become more conservative, especially in children. [11] This could potentially lead to more infections not being treated properly and having a higher likelihood of subsequent complications such as Lemierre's. The recent resurgence of LS suggests physicians need to keep the disease in their minds when treating head and neck infections in patients.…”

Section: Discussionmentioning

confidence: 99%

Lemierre’s Syndrome: A Thing of the Past?

Dhaduk

Vedula²,

Govindan

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction: Lemierre’s syndrome (LS), infectious thrombophlebitis of the internal jugular vein, is a rare, life-threatening complication of oropharyngeal infections underrepresented in literature. We reviewed the etiology, clinical characteristics, treatment regiments and prognosis of LS in pediatric patients.Methods: PubMed and MEDLINE were searched from February 10, 2018 to July 28, 2018 for relevant studies. A systematic review was performed using the terms LS and pediatric case. Our criteria included reviews, case reports, and case series with patients under 18 years with a diagnosis of LS. Results: 70 cases of pediatric LS were identified. The male to female ratio was 1:1.7 with an average age of 10.7 years (5 weeks to 17 years). The most common initial clinical presentations were fever (90.0%), sore throat (38.6%), and neck pain or tenderness (35.7%), while the most frequent findings on physical exam were fever (31.4%) and neck involvement (28.6%). F. necrophorum was the predominant organism cultured (62.9%). Septic emboli were seen in 51.4% of cases with the lungs affected in 40 patients. Most commonly used treatments were antibiotics (91.4%) followed by anticoagulation (50.0%) and the overall mortality rate was 8.6%. The average time from initial presentation to diagnosis was 4.9 days. Conclusion: LS is a deadly condition with a staggering mortality rate despite the advent of antibiotic measures. Early identification and a high index of suspicion are necessary to prevent complications associated with LS. Despite its rarity it should remain on the differential for any patient with toxic signs and localized neck findings.

show abstract

“…Lemierre's syndrome (LS), first described by French bacteriologist Andre-Alfred Lemierre, is characterized by an oropharyngeal infection resulting in septic thrombophlebitis of the internal jugular vein (IJV) followed by septic embolization [1,2]. In 1936, Lemierre reported twenty young, healthy adult patients initially diagnosed with pharyngotonsillitis and peritonsillar abscesses who subsequently developed neck swelling and tenderness secondary to septic thrombophlebitis of the IJV with metastatic abscesses and anaerobic septicemia.…”

Section: Introductionmentioning

confidence: 99%

“…This syndrome, however, has been reported more frequently in the last twenty years, a phenomenon that has been attributed to increased awareness, increased availability of diagnostic modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), and increasing antibiotic stewardship. Indeed, if fewer patients are aggressively treated for bacterial infections, then there is an increase in syndrome susceptibility [1,[5][6][7]. Nevertheless, LS is very rare in developed countries with an estimated incidence of one case per million per year [5,7].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Lemierre's Syndrome Caused by Streptococcus Intermedius, Presenting as an Epidural Abscess

Anupama

Gilotra

Tymko

et al. 2020

Cureus

View full text Add to dashboard Cite

Lemierre's syndrome is a rare but life-threatening condition characterized by an oropharyngeal infection typically secondary to Fusobacterium necrophorum resulting in septic thrombophlebitis of the internal jugular vein. Streptococcus intermedius is a particularly rare cause of Lemierre's syndrome with only a few cases reported in the literature. Here we describe a rare case of Lemierre's syndrome, caused by Streptococcus intermedius, likely secondary to an odontogenic infection, found to have a cervical epidural abscess with concomitant large retropharyngeal and prevertebral abscesses on presentation, in whom the clinical course was further complicated by an extensive cerebral venous sinus thrombosis. However, despite grave complications, early diagnosis and appropriate emergency management including intravenous antibiotics and surgical intervention led to a successful recovery, thus demonstrating that aggressive measures can potentially lead to a favorable outcome.

show abstract

Lemierre’s syndrome: Case report and brief literature review

Cited by 10 publications

References 19 publications

Lemierre’s Syndrome: A Case of Life-Threatening Infection From Family Medicine Practice

Lemierre’s Syndrome: A Case of Life-Threatening Infection From Family Medicine Practice

Lemierre’s Syndrome: A Thing of the Past?

A Rare Case of Lemierre's Syndrome Caused by Streptococcus Intermedius, Presenting as an Epidural Abscess

Contact Info

Product

Resources

About