scholarly journals Lemierre’s Syndrome: Rare, but Life Threatening—A Case Report withStreptococcus intermedius

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Shalini Gupta ◽  
Shehzad S. Merchant
Keyword(s):  
Early Recognition ◽  
Diagnostic Delay ◽  
Fusobacterium Necrophorum ◽  
Antimicrobial Treatment ◽  
Lemierre’S Syndrome ◽  
Presenting Symptoms ◽  
Oropharyngeal Infection ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
Early Phases

Lemierre’s syndrome (LS) is a rare, but a life-threatening complication of an oropharyngeal infection. Combinations of fever, pharyngitis, dysphagia, odynophagia, or oropharyngeal swelling are common presenting symptoms. Infection of the lateral pharyngeal space may result in thrombosis of the internal jugular vein, subsequent metastatic complications (e.g., lung abscesses, septic arthritis), and significant morbidity and mortality. LS is usually caused by the gram-negative anaerobic bacillusFusobacterium necrophorum, hence also known as necrobacillosis. We present a case of LS caused byStreptococcus intermedius, likely secondary to gingival scraping, in which the presenting complaint was neck pain. The oropharyngeal examination was normal and an initial CT of the neck was done without contrast, which likely resulted in a diagnostic delay. This syndrome can be easily missed in early phases. However, given the potential severity of LS, early recognition and expedient appropriate antimicrobial treatment are critical.S. intermediusis an unusual cause of LS, with only 2 previous cases being reported in the literature. Therefore, an awareness of the myriad presentations of this syndrome, which in turn will lead to appropriate and timely diagnostic studies, will result in improved outcome for LS.

scholarly journals Lemierre’s Syndrome: Case Presentation of a Rare and Possibly Life-Threatening Condition

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1102
Author(s):  
Lucian Giubelan ◽  
Livia Dragonu ◽  
Vlad Pădureanu ◽  
Alexandru Neacșu ◽  
Mirela Mănescu ◽  
...  
Keyword(s):  
Jugular Vein ◽  
Anaerobic Bacteria ◽  
Rare Condition ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Case Presentation ◽  
Oropharyngeal Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Lemierre's Syndrome

Lemierre’s syndrome is, presently, a very rare condition, but a life-threatening one. The syndrome was first described in 1936 by Andre Lemierre and comprises an oropharyngeal infection (most commonly associated with anaerobic bacteria Fusobacterium necrophorum), internal jugular vein thrombophlebitis and, possibly, secondary septic metastasis (common sites are lungs or brain). We describe such a rare case diagnosed at our Infectious Diseases Department in September 2019.

scholarly journals Fusobacterium necrophorumsepsis after tonsillitis/pharyngitis

2019 ◽  
Vol 12 (1) ◽  
pp. e222287 ◽  
Author(s):  
Micheal Sheehan ◽  
Darren McLoughlin ◽  
Ronan O’Sullivan
Keyword(s):  
Early Recognition ◽  
Rare Condition ◽  
Fusobacterium Necrophorum ◽  
Adverse Outcomes ◽  
Lemierre’S Syndrome ◽  
Metastatic Focus ◽  
Oropharyngeal Infection ◽  
History Of ◽  
Lemierre’S Disease ◽  
Lemierre's Syndrome

Fusobacterium necrophorumis a rare infection most notable for causing Lemierre’s syndrome. This consists of a primary oropharyngeal infection and septic thrombophlebitis, and one or more metastatic focus. Prior to the widespread use of antibiotics, Lemierre’s syndrome commonly followed a rapidly progressing course, with a high mortality. We describe a case of a previously well 18-month-old boy who presented to the emergency department with a 3-week history of progressive, right-sided, painful neck swelling and systemic sepsis. He was initially treated conservatively with intravenous antibiotics, but ultimately required surgical drainage. Lemierre’s syndrome is a rare condition with increasing incidence which can have significant adverse outcomes including death. Early recognition and treatment are essential, but identifying Lemierre’s disease is challenging.

Lemierre’s syndrome

2021 ◽  
pp. practneurol-2021-002928
Author(s):  
Eng Chuan Foo ◽  
Matthew Tanti ◽  
Helen Cliffe ◽  
Marc Randall
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Cervical Lymphadenopathy ◽  
Fusobacterium Necrophorum ◽  
Good Prognosis ◽  
Hemicrania Continua ◽  
Lemierre’S Syndrome ◽  
Presenting Symptoms ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare and potentially life-threatening condition that follows an oropharyngeal infection, typically from Fusobacterium necrophorum, and usually affects healthy adolescents or young adults. The characteristic features are septic thrombophlebitis of the internal jugular vein and septic embolism leading to multiorgan involvement, commonly the brain, lungs and bones. We report a man with presenting symptoms suggesting hemicrania continua, whose initial imaging showed no features of dural venous sinus or jugular thrombosis. Two weeks later, he had fever, sore throat, cervical lymphadenopathy and Actinomyces meyeri grew from peripheral blood cultures. Further imaging identified thrombosis of the internal jugular vein and cerebral venous sinuses, with multifocal cavitating lung lesions. Following antibiotics and anticoagulation, he recovered without residual deficits. Lemierre’s syndrome when recognised and treated early has a good prognosis but delayed treatment may result in significant morbidity or mortality.

scholarly journals The Forgotten Disease: A Case of Lemierre’s Syndrome with Distal Extremity Involvement

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
John Gaskill ◽  
Michael Aronson
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Rare Condition ◽  
Fusobacterium Necrophorum ◽  
Lemierre’S Syndrome ◽  
Intravenous Antibiotics ◽  
Adjacent Structures ◽  
Oropharyngeal Infection ◽  
Fluid Collections ◽  
Lemierre's Syndrome

Once coined the “Forgotten Disease,” Lemierre’s syndrome is a rare condition that results from oropharyngeal infection with the gram-negative, anaerobic Fusobacterium necrophorum. The typical progression of illness involves spread to adjacent structures such as the internal jugular vein with resulting thrombophlebitis. Septic emboli to distant sites are also a common sequela. Here, we present a case of Lemierre’s syndrome in a 20-year-old, otherwise healthy, male. The patient presented with fever, sore throat, and dysphagia. Imaging revealed peritonsillar multiloculated fluid collections and necrotizing pneumonia with multiple pulmonary abscesses. The patient’s hospital course was complicated by the development of necrotizing fasciitis in his right lower leg, which required incision and drainage with surgical washout. In addition to systemic intravenous antibiotics and anticoagulation, he underwent multiple thoracentesis procedures. The patient was ultimately transferred to a tertiary care center due to persistent fevers and lung abscesses. This case highlights the challenges of initial diagnosis, as well as the treatment choices faced by the attending physicians.

A rare, but life-threatening sore throat: A case of Lemierre’s syndrome

2021 ◽  
Vol 20 (1) ◽  
pp. 78-82
Author(s):  
A McCleane ◽  
◽  
M Hunter ◽  
PC Johnston ◽  
M Trimble ◽  
...  
Keyword(s):  
Sore Throat ◽  
Fusobacterium Necrophorum ◽  
Lung Abscess ◽  
Lemierre’S Syndrome ◽  
Blood Tests ◽  
Threatening Condition ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
Initial Blood ◽  
Electrolyte Abnormalities

We present the case of a previously healthy, immunocompetent male with Lemierre’s Syndrome. He presented with headache, sore throat and pyrexia. Initial blood tests revealed raised inflammatory markers and electrolyte abnormalities. Blood cultured Fusobacterium necrophorum. He developed respiratory distress and imaging confirmed lung abscess and empyema due to septic emboli. He required surgical drainage and a prolonged course of antibiotics. This case highlights the rare, but life-threatening condition of Lemierre’s Syndrome. We discuss the importance of prompt recognition and early antibiotic therapy.

Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report

2007 ◽  
Vol 122 (5) ◽  
pp. 527-530 ◽  
Author(s):  
S Georgopoulos ◽  
S Korres ◽  
M Riga ◽  
D Balatsouras ◽  
G Kotsis ◽  
...  
Keyword(s):  
Case Report ◽  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Consumption Coagulopathy ◽  
Lemierre’S Syndrome ◽  
Acute Tonsillitis ◽  
Respiratory Deficiency ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
High Index Of Suspicion

AbstractBackground:Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.Case report:The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.Conclusion:The usual causative pathogen, namelyFusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.

scholarly journals Lemierre’s Syndrome Associated with Mechanical Ventilation and Profound Deafness

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Lukas Birkner
Keyword(s):  
Mechanical Ventilation ◽  
Cochlear Implant ◽  
Jugular Vein ◽  
Lemierre’S Syndrome ◽  
Oropharyngeal Infection ◽  
Profound Deafness ◽  
Ventilation Support ◽  
Mechanical Ventilation Support ◽  
Life Threatening ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare disorder that is characterized by anaerobic organisms inducing a thrombophlebitis of the internal jugular vein (IJV) following a course of oropharyngeal infection. It often occurs in young and healthy patients. Clinicians continuously misinterpret early symptoms until infection disseminates systematically and life-threatening sepsis transpires. We report the case of a 58-year-old female developing Lemierre’s syndrome accompanied by invasive ventilation support and a profound deafness requiring the implementation of a cochlear implant. This is one of two reported cases of Lemierre’s syndrome associated with mechanical ventilation support and the only case associated with a cochlear implant.

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

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Abrakhom Zeyni ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatic Vein ◽  
Abdominal Ultrasound ◽  
Fusobacterium Necrophorum ◽  
Watery Diarrhea ◽  
Lemierre’S Syndrome ◽  
Vein Thrombosis ◽  
Hepatic Vein Thrombosis ◽  
Oropharyngeal Infection ◽  
Lemierre's Syndrome

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.

scholarly journals Abdominal variant of Lemierre’s Syndrome in a Patient with Pancreatic Adenocarcinoma

2021 ◽  
Author(s):  
Yavuz Furuncuoğlu ◽  
Bala Başak Oven ◽  
Başak Mert ◽  
Enis Çağatay Yılmaz ◽  
Mustafa Kemal Demir
Keyword(s):  
Jugular Vein ◽  
Fusobacterium Necrophorum ◽  
Infectious Agents ◽  
Resonance Imaging ◽  
Lemierre’S Syndrome ◽  
Gastrointestinal Malignancies ◽  
Life Threatening ◽  
Weighted Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Lemierre's Syndrome

Lemierre’s syndrome is an illness characterized by internal jugular vein thrombophlebitis related to infectious agents, primarily Fusobacterium necrophorum. These bacteria, residing in both the oropharynx and the gastrointestinal tract, may lead to pylephlebitis, a serious condition that could result in the development of hepatic abscesses. This manifestation of the disease is regarded as the abdominal variant of Lemierre’s syndrome. Patients with gastrointestinal malignancies, especially those who undergo surgeries, are susceptible to the abdominal variant of Lemierre’s syndrome. Timely diagnosis is required to avoid the life-threatening complications of the abdominal variant of Lemierre’s syndrome. Diffusion-weighted magnetic resonance imaging (MRI) might be very useful in differentiating this disease from liver metastasis in patients with malignancies. Radiologists and clinicians need to be aware of this challenging condition to prevent misdiagnosis, since prompt treatment is often lifesaving.

Lemierre’s syndrome: a forgotten life-threatening entity

2020 ◽  
Vol 13 (10) ◽  
pp. e236201
Author(s):  
Rita Gama ◽  
Manuel Sousa ◽  
Fernanda Castro ◽  
Artur Condé
Keyword(s):  
Jugular Vein ◽  
Final Diagnosis ◽  
Fusobacterium Necrophorum ◽  
Peritonsillar Abscess ◽  
Adult Males ◽  
Lemierre’S Syndrome ◽  
Family Doctors ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
Nose And Throat

Lemierre’s syndrome is a very rare but potentially fatal condition. It mainly affects adolescents and young adult males, and usually arises as a serious complication of pharyngitis or peritonsillar abscess. It is characterised by the triad of internal jugular vein septic thrombophlebitis, septic emboli (mostly pulmonary) and the isolation of the agent ‘Fusobacterium necrophorum’ in sterile fluids. In this report, it is described a case in which the nonspecific and subtle clinic made the diagnosis difficult to reach. In fact, only the dissociation between flu-like symptoms and the presence of significant changes in the blood tests (suggestive of acute bacterial infection), led to the request for imaging tests, which proved to be essential for the final diagnosis and subsequent control of the disease. This case report aims to increase the awareness among Ear, Nose and Throat (ENT) residents, paediatricians and family doctors about the existence of this entity and its potential life-threatening nature.

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