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.

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.

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 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.

scholarly journals Atypical Presentation of Lemierre’s Syndrome Causing Septic Shock and Acute Respiratory Distress Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Divyesh Reddy Nemakayala ◽  
Manoj P Rai ◽  
Shilpa Kavuturu ◽  
Supratik Rayamajhi
Keyword(s):  
Septic Shock ◽  
Young Female ◽  
Sudden Onset ◽  
Lemierre’S Syndrome ◽  
Oropharyngeal Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Chest X Ray ◽  
Lemierre’S Disease ◽  
Lemierre's Syndrome

Lemierre’s disease is a rare but life-threatening condition characterized by an oropharyngeal infection complicating with thrombophlebitis of the internal jugular vein and disseminated abscesses. We are presenting a case of a young female who initially presented with fevers, chills, sore throat, and swollen neck later developed progressively worsening shortness of breath along with sudden onset pleuritic chest pain. She then developed progressively worsening acute hypoxic respiratory failure requiring intubation and mechanical ventilation. Interval chest X-ray showed worsening bilateral effusions. She also developed septic shock requiring pressors. Blood culture showed Fusobacterium, and antibiotics were changed accordingly following which there was a clinical improvement. The diagnosis of Lemierre’s syndrome was then established based on her presenting age and bilateral pulmonary empyema in the setting of septicemia with Fusobacterium.

scholarly journals Lemierre’s syndrome: a life-threatening sore throat

2018 ◽  
pp. bcr-2018-227907
Author(s):  
Hiroshi Sugimoto ◽  
Atsushi Kitamura
Keyword(s):  
Sore Throat ◽  
Lemierre’S Syndrome ◽  
Life Threatening ◽  
Lemierre's Syndrome

scholarly journals Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminated Fusobacterium necrophorum infection during the global COVID-19 pandemic

2020 ◽  
Vol 13 (10) ◽  
pp. e239269
Author(s):  
Fergal Howley ◽  
Laura O'Doherty ◽  
Niall McEniff ◽  
Ruth O'Riordan
Keyword(s):  
Young Male ◽  
Fusobacterium Necrophorum ◽  
Healthcare Services ◽  
Global Scale ◽  
Late Presentation ◽  
Medical Attention ◽  
Dental Infection ◽  
Lemierre’S Syndrome ◽  
Life Threatening ◽  
Lemierre's Syndrome

The SARS-CoV-2 outbreak has disrupted the delivery of routine healthcare services on a global scale. With many regions suspending the provision of non-essential healthcare services, there is a risk that patients with common treatable illnesses do not receive prompt treatment, leading to more serious and complex presentations at a later date. Lemierre’s syndrome is a potentially life-threatening and under-recognised sequela of an oropharyngeal or dental infection. It is characterised by septic embolisation of the gram-negative bacillus Fusobacterium necrophorum to a variety of different organs, most commonly to the lungs. Thrombophlebitis of the internal jugular vein is frequently identified. We describe an atypical case of Lemierre’s syndrome involving the brain, liver and lungs following a dental infection in a young male who delayed seeking dental or medical attention due to a lack of routine services and concerns about the SARS-CoV-2 outbreak.

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.

Life Threatening Complication of Sore Throat: Lemierre’s Syndrome

2012 ◽  
Vol 80 (12) ◽  
pp. 1059-1061 ◽  
Author(s):  
Arif Khan ◽  
Subramanian Ganesan ◽  
Manish Arora ◽  
Nahin Hussain
Keyword(s):  
Sore Throat ◽  
Lemierre’S Syndrome ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Lemierre's Syndrome

scholarly journals Severe Sepsis Associated with Lemierre’s Syndrome: A Rare but Life-Threatening Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Audrey Tawa ◽  
Raphaëlle Larmet ◽  
Yannick Malledant ◽  
Philippe Seguin
Keyword(s):  
Fusobacterium Necrophorum ◽  
Blood Analysis ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
Lemierre’S Syndrome ◽  
Surgical Intensive Care ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Lemierre's Syndrome

Background.The incidence of Lemierre’s syndrome has increased in the past decade. This posttonsillitis complication may be life threatening.Case Presentation.A 19-year-old patient was admitted to Surgical Intensive Care Unit of a French University Hospital for high fever, low blood pressure, and haemoptysis following a sore throat episode. Blood analysis revealed a thrombopenia, an acute renal failure, and an elevated lactate serum.Fusobacterium necrophorumwas found in blood cultures. Computed tomography of the neck and lungs confirmed the diagnosis of Lemierre’s syndrome: pleural effusions, bilateral lung infiltrates, and an internal jugular vein thrombosis. Fluid administration and antibiotic treatment were quickly initiated. Patient left the unit four days after his admission without any organ dysfunction.Conclusion.Lemierre’s syndrome may lead to multiorgan dysfunction and should be rapidly identified.

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