Sore Throat, Fever, Septic Emboli, and Acute Respiratory Distress Syndrome: A Case of Lemierre Syndrome

Jafri, Farrukh N; Shulman, Jodi; Gómez-Márquez, José C.; Lazarus, Matthew S.; Ginsburg, David M.

doi:10.1155/2018/7373914

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…42,64 In people, F. necrophorum causes Lemierre syndrome, an acute oropharyngeal infection accompanied by internal jugular thrombophlebitis. 41 Overall, determining the significance of culturing any of these bacteria is difficult due to a dearth of literature on their pathogenicity in rhesus macaques. This underscores the need for increased reporting of infectious disease in rhesus macaques in order to better inform treatment decisions when potential pathogens are cultured.…”

Section: Discussionmentioning

confidence: 99%

Hematology and Culture Assessment of Cranially Implanted Rhesus Macaques (Macaca mulatta)

et al. 2021

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The use of percutaneous cranial implants in rhesus macaques (Macaca mulatta) has long been a valuable tool for neuroscienceresearch. However, when treating and assessing these animals, veterinarians are required to make assumptions aboutdiagnostic results due to a lack of research into how these implants affect physiology. Microbial cultures of cranial implant sites show an abundance of colonizing bacteria, but whether these microbes affect animal health and wellbeing is poorly understood. In addition, microbial antibiotic resistance can present significant health concerns for both the animals and the researchers. To help elucidate the relationship between percutaneous cranial implants and blood parameters, complete blood cell counts and serum chemistry results were assessed on 57 nonhuman primates at our institution from September 2001 toMarch 2017. Generalized estimating equations were used to compare the results before and after an animal’s first implantsurgery. This modelling showed that cranial implants were a significant predictor of alterations in the number of neutrophils,lymphocytes, and red blood cells, and in the concentration of hemoglobin, alkaline phosphatase, creatinine, calcium, phosphorus,total protein, albumin, and globulin. Anaerobic and aerobic bacterial cultures were performed to identify bacteria associated with cranial implants. Staphylococcus spp., Streptococcus spp., and Corynebacterium spp. comprised the majority of the aerobic bacterial isolates, while Fusobacterium spp., Peptostreptococcus spp. and Bacterioides fragilis comprised the majority of anaerobic bacterial isolates. Using a Pearson r correlation for statistical analysis, we assessed whether any of thesebacterial isolates developed antibiotic resistances over time. Cefazolin, the most frequently used antibiotic in monkeys inthis study, was the only antimicrobial out of 41 agents tested to which bacteria developed resistance over time. These resultsindicate that percutaneous implants are associated with a generalized inflammatory state, multiple bacterial species are present at the implant site, and these bacteria may contribute to the inflammatory response

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Section: Discussionmentioning

confidence: 99%

Hematology and Culture Assessment of Cranially Implanted Rhesus Macaques (Macaca mulatta)

et al. 2021

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“…LS, previously known as 'the forgotten disease' for its rarity, is nowadays growing. Some studies have suggested that the reason for this increase is antibiotic resistance, changes in prescription patterns, or the increased efficiency of diagnostic technologies (5). Other studies have reported the link between the use of non-steroidal antiinflammatory drugs and steroids and the enhanced bacterial virulence and spread (6).…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of LS can be difficult, and is often prompted by the identification of F. necrophorum in blood cultures. It requires a high degree of clinical suspicion along with data indicating thrombophlebitis, sepsis, or septic emboli (5). Imaging finding help through the diagnostic process.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Variant of Lemierre’s Syndrome with Multiple Abscesses and Hepatic Vein Thrombosis

et al. 2020

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Introduction: Lemierre’s syndrome is an uncommon, life-threatening disease that develops as a severe complication of oropharyngeal infection. However, this syndrome has also been reported during anaerobic septicemia, originating from diverse sources of infection, such as the gastrointestinal system. The diagnosis of this syndrome remains challenging, and is often prompted by the detection of Fusobacterium necrophorum in blood culture, rather than with clinical signs or symptoms. Case Presentation: A previously healthy 38-year-old woman was hospitalized for a 6-day history of fever, watery diarrhea, and vomiting. Physical examination of the patient showed fever, pharyngitis, and diffuse abdominal tenderness. Laboratory investigations revealed elevated inflammatory markers, and two blood cultures revealed Fusobacterium necrophorum. An abdominal ultrasound showed a liver abscess and hepatic vein thrombosis. The thoracoabdominal and cerebral computed tomography scan confirmed the results of the abdominal ultrasound. It additionally revealed bilateral lung nodules and a parietal brain abscess. The patient’s general condition and her laboratory test results, improved after receiving treatment with ceftriaxone and metronidazole. She received antibiotics for three months, without anticoagulation therapy. Repeated computed tomography scans showed a resolution of the liver, pulmonary, and brain abscesses, as well as the recanalization of the hepatic vein. Conclusions: Lemierre’s syndrome emerges as a result of septic illness and liver abscesses in case of gastrointestinal symptoms despite the lack of common presentation.

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“…In 1900 physicians Courmount and Cade for the first time identified a condition as infection of the oropharynx which was caused by anaerobic bacteria leading to the formation of infective pulmonary infarcts after attaining intravascular entry. Later on, Goldman and Mosher in the years 1917 and 1920 and Fränkel in 1925 explained the conversion of simple infection of tonsils to thrombophlebitis of the tonsillar veins, along with the formation of a septic thrombus in the Internal jugular vein and its putrefaction into multiple septic emboli [8,9]. But even after appreciable work on this condition they were not able to find out the agent that gave rise to this deadly condition.…”

Section: Reviewmentioning

confidence: 99%

Lemierre's Syndrome: A Lethal Complication of Acute Tonsillitis

Amarnani¹,

Ranjan²

2022

Cureus

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Tonsillitis is a condition involving the infection of the lymphoid tissue of the tonsils. This pathology of the tonsils is frequently reported as a childhood illness in children of school-going age. The leading causative agent which is associated with tonsillitis is Group A and B Haemolytic Streptococcus and Staphylococcus and Haemophilus influenzae. With rapid and correct treatment and management with antibiotics and analgesics, it can be resolved, and the patient can be free of the symptoms such as sore throat, dysphagia, pain over the throat, and fever. Though in the minority of cases the diseases can progress and can result in multiple complications which sometimes can be lethal and extremely serious. These can be rheumatic fever, acute glomerulonephritis, or tonsillar cyst. One of the sporadic but equally important and grave syndromes is Lemierre's syndrome, which unfortunately has been labelled as a forgotten disease due to the development of antibiotic therapy and management of the disease. The mortality of the disease was extremely high in the pre-antibiotic era. This disease presents the following findings, such as thrombophlebitis of the internal jugular vein, which usually occurs after the presentation of pharyngeal infection. Which in later stages also gives rise to thrombi that advance and extend throughout the body, in the form of septic emboli. The important microorganism which is isolated and associated with the Lemierre's is Fusobacterium necrophorum, a strict gram-negative anaerobe. This article emphasizes and discusses the pathophysiology, and microbiology of Lemierre's syndrome. It also focuses on the clinical symptoms that include the appropriate and timely diagnosis and treatment of this deadly and fatal syndrome, together with the complications that arise with Lemierre's syndrome as the presenting problem.

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Sore Throat, Fever, Septic Emboli, and Acute Respiratory Distress Syndrome: A Case of Lemierre Syndrome

Cited by 5 publications

References 9 publications

Hematology and Culture Assessment of Cranially Implanted Rhesus Macaques (Macaca mulatta)

Hematology and Culture Assessment of Cranially Implanted Rhesus Macaques (Macaca mulatta)

An Unusual Variant of Lemierre’s Syndrome with Multiple Abscesses and Hepatic Vein Thrombosis

Lemierre's Syndrome: A Lethal Complication of Acute Tonsillitis

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