Pylephlebitis Complicated by Hepatic Abscesses due to Fusobacterium Nucleatum: A Case of Lemierre's Syndrome Variant and Literature Review

Jaber, Fouad; Alsakarneh, Saqr; Campbell, John C.; Awad, Adiveh; Mohamed, Wael T.; Wittler, Kaitlin; Ghoz, Hassan; Clarkston, Wendell K.

doi:10.14309/crj.0000000000001046

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Thrombosis can present as internal jugular thrombophlebitis in Lemierre syndrome, while as portal and superior mesenteric vein thromboses in the GI variant of Lemierre syndrome. 11 The lung is the most frequently involved organ, manifesting as septic pulmonary embolism, pleural effusion, abscess chest, and pneumothorax. 12 In this case of the present study, we not only detected pathogenic bacteria ( Fusobacterium necrophorum ) in the BALF sample using mNGS testing, but also found significant pathological changes in the lungs (eg, multiple cavitary lesions bilaterally, left hydropneumothorax, and left pleural effusion) ( Figure 1 ).…”

Section: Discussionmentioning

confidence: 99%

Lemierre Syndrome: Report of a Case with an Innovative Diagnostic Method and Literature Review

Xie,

Liu,

Zheng

et al. 2024

IDR

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Objective To understand the clinical features, diagnosis and treatment of Lemierre syndrome (LS), a high-risk and low-prevalence infectious disease. Methods We present the severe LS case that was diagnosed using metagenomic next-generation sequencing (mNGS) in our hospital, and systematically summarized the diagnosis and treatment strategies of patients that reported LS from 2006 to 2022. Results The 24-year-old patient in our hospital suffered from cranial nerve paralysis, a neurological complication rarely seen in LS cases. The causative agent ( Fusobacterium necrophorum , Fn) of this patient was only detected by mNGS tests, and the reads number of Fn detected by plasma mNGS tests was decrease as the patients gradually improved, indicating plasma mNGS is valuable in monitoring treatment efficacy. Although most of the cases retrieved from the literature showed typical symptoms, such as a history of sore throat, septic emboli, and internal jugular vein thrombosis, clinical manifestations were still relatively heterogeneous (eg, diversity of predisposing factors and pathogens, differences in pulmonary imaging features). Conclusion We summarized the clinical presentation, diagnosis, treatment, and regression of 17 symptomatic cases reported LS to provide clinicians with knowledge about this rare but fatal disease. mNGS assays should be considered as early as possible to identify the responsible pathogens for acute and critically ill patients with suspected infections in order to implement accurate and effective treatment.

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Section: Discussionmentioning

confidence: 99%