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BACKGROUND: Lemierre's syndrome is a fatal and rare disease that is typically characterized by oropharyngeal infection and internal jugular vein thrombosis. Timely institution of appropriate antibiotics is the standard treatment. CASE PRESENTATION: The authors report a case of Lemierre's syndrome. A 67-year-old male patient of Han ethnicity in China suffered from a large inflammatory neck mass involving left internal jugular vein thrombosis diagnosed as Lemierre's syndrome and finally cured by surgical treatment. In addition, a literature review was carried out through PubMed using the terms "Lemierre's syndrome/disease and review, meta-analysis or retrospective study" and "Lemierre's syndrome/disease and internal jugular vein". This search yielded six articles that recorded surgical methods such as drainage, craniotomy, tooth extraction, and ligation of the occluded vein to give clinicians more ideas about the treatment of the Lemierre's syndrome. CONCLUSION: This is the first review to summarize the conditions under which surgical treatment are conducted. Additionally, this is the first report of such a large inflammatory neck mass that was completely cured by surgical resection and internal jugular vein ligation. The authors also offer several conclusions regarding surgical intervention in Lemierre's syndrome for the first time.
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Venas Yugulares , Síndrome de Lemierre , Humanos , Síndrome de Lemierre/cirugía , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamiento farmacológico , Masculino , Venas Yugulares/cirugía , Anciano , Resultado del Tratamiento , Ligadura , Antibacterianos/uso terapéutico , Drenaje , Tomografía Computarizada por Rayos X , Trombosis de la Vena/cirugíaRESUMEN
Lemierre syndrome is a rare complication of oropharyngeal infection, especially acute pharyngotonsillitis, associated with septicemia and thrombophlebitis of the internal jugular vein (IJV). We present the case of a 52-year-old patient who underwent liver transplantation and returned with symptoms of pain, redness and left cervical bulging 1 month after surgery. After investigation, the diagnosis of septic thrombophlebitis of the IJV was made. The patient responded well to treatment with antibiotic therapy and full anticoagulation. To the best of our knowledge, the present report is the first report of Lemierre syndrome in a post-liver transplant patient.
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Síndrome de Lemierre , Sepsis , Tromboflebitis , Antibacterianos/uso terapéutico , Humanos , Huésped Inmunocomprometido , Venas Yugulares/diagnóstico por imagen , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/cirugía , Persona de Mediana Edad , Sepsis/complicaciones , Sepsis/etiología , Tromboflebitis/diagnóstico por imagen , Tromboflebitis/tratamiento farmacológicoAsunto(s)
Venas Yugulares/patología , Síndrome de Lemierre/diagnóstico , Administración Intravenosa , Adolescente , Antibacterianos/administración & dosificación , Femenino , Humanos , Venas Yugulares/diagnóstico por imagen , Síndrome de Lemierre/tratamiento farmacológico , Síndrome de Lemierre/microbiología , Síndrome de Lemierre/cirugía , Trombosis/diagnóstico por imagen , Trombosis/microbiología , Tomografía Computarizada por Rayos XRESUMEN
Lemierre syndrome is an uncommon condition in which internal jugular vein thrombosis presents after recent oropharyngeal infection. Frequently, this is accompanied by septic emboli. This report outlines a variant of this disease process, with septic thrombophlebitis of the neck associated with a necrotizing skin infection of the lower lip and chin. A 25-year-old man with lower lip and chin swelling, initially managed with intravenous antibiotics, progressed to the development of a left facial vein thrombus, septic emboli to the lungs, and a necrotizing lower lip and chin infection that was managed with debridement, thrombectomy, and prolonged hemodynamic and pulmonary support. A necrotizing skin infection with thrombus of the jugular system and septic emboli is a very rare variant of Lemierre syndrome. Early recognition of an infection with septic emboli and/or necrotizing pathobiological findings allows for prompt antibiotic and surgical therapy, minimizing the mortality of these potentially lethal infections.
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Síndrome de Lemierre/diagnóstico por imagen , Síndrome de Lemierre/cirugía , Enfermedades de los Labios/diagnóstico por imagen , Enfermedades de los Labios/cirugía , Tromboflebitis/diagnóstico por imagen , Tromboflebitis/cirugía , Tomografía Computarizada por Rayos X , Adulto , Humanos , Masculino , Cuello , Necrosis , Sepsis/diagnóstico por imagen , Sepsis/terapiaAsunto(s)
Síndrome de Lemierre/diagnóstico por imagen , Trastornos de Deglución/etiología , Disnea/etiología , Fiebre/etiología , Ronquera/etiología , Humanos , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/cirugía , Masculino , Persona de Mediana Edad , Dolor de Cuello/etiología , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Lemierre's syndrome is a rare condition characterised by pharyngitis leading to septic thrombophlebitis of the internal jugular vein. Complications include pulmonary septic emboli, septic arthritis and disseminated intravascular coagulation. The authors present a case of a healthy woman aged 25 years with septic arthritis of the shoulder due to this unusual cause. This diagnosis was made via a combination of clinical, radiological and microbiological findings. It was successfully treated via surgical and antimicrobial interventions. The patient made a good recovery with minimal associated morbidity or loss of function. This case highlights the importance for awareness and high index of suspicion for rarer causes of septic arthritis in young healthy adults as early appropriate intervention maximises prognosis.
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Artritis Infecciosa/diagnóstico , Síndrome de Lemierre/diagnóstico , Articulación del Hombro , Adulto , Artritis Infecciosa/complicaciones , Artritis Infecciosa/diagnóstico por imagen , Artritis Infecciosa/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/diagnóstico por imagen , Síndrome de Lemierre/cirugía , Imagen por Resonancia MagnéticaRESUMEN
Lemierre syndrome is a rare condition arising from an invasive oropharyngeal infection, which leads to septic thrombophlebitis of the internal jugular vein and multi-organ septic embolization. Intracranial complications are rare but serious, including subdural empyema, cavernous sinus thrombosis, and internal carotid artery aneurysms. We report a patient with Lemierre syndrome with multiple intracranial complications despite aggressive antimicrobial therapy. The patient eventually required transsphenoidal endoscopic drainage of the sphenoid sinus to help eradicate the infectious source. We postulate that in patients with Lemierre syndrome with evidence of infection in the paranasal sinuses, endoscopic sinus drainage can be an adjunct to antimicrobial therapy in achieving infection control.
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Síndrome de Lemierre/cirugía , Seno Esfenoidal/cirugía , Adulto , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/etiología , Enfermedades de las Arterias Carótidas/patología , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/patología , Angiografía Cerebral , Drenaje/métodos , Endoscopía/métodos , Estudios de Seguimiento , Cabeza/diagnóstico por imagen , Cabeza/patología , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/etiología , Aneurisma Intracraneal/patología , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Seno Esfenoidal/diagnóstico por imagen , Seno Esfenoidal/patología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
INTRODUCTION: Lemierre's syndrome is a potentially fatal condition characterised by spread of an oropharyngeal infection, resulting in thrombosis of the internal jugular vein. This leads to septicaemia and possible metastatic abscesses. CASE PRESENTATION: We discuss the case of a previously healthy 17-year-old male who developed Lemierre's syndrome following dental sepsis. He presented with bilateral submandibular and submental swelling extending into the neck and chest. His management included a tracheostomy; incision and drainage of the abscesses; drainage of a pleural effusion and prolonged anticoagulant therapy. CONCLUSION: The incidence of Lemierre's disease appears to be increasing and early diagnosis is essential. A high index of suspicion is needed in cases of oropharyngeal infection followed by fever, tender swelling of the neck and dysphagia - especially in young patients.
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Infección Focal Dental/complicaciones , Síndrome de Lemierre/etiología , Adolescente , Anticoagulantes/uso terapéutico , Drenaje , Humanos , Síndrome de Lemierre/cirugía , Masculino , Derrame Pleural/etiología , Derrame Pleural/cirugía , TraqueostomíaAsunto(s)
Síndrome de Lemierre/cirugía , Diagnóstico Diferencial , Femenino , Infecciones por Fusobacterium/diagnóstico , Fusobacterium necrophorum/aislamiento & purificación , Humanos , Venas Yugulares/diagnóstico por imagen , Venas Yugulares/cirugía , Síndrome de Lemierre/diagnóstico , Absceso Pulmonar/diagnóstico por imagen , Masculino , Derrame Pleural/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/cirugía , Adulto JovenRESUMEN
BACKGROUND: Septic thrombophlebitis of the internal jugular vein, known as Lemierre syndrome, is a rare disorder usually caused by Fusobacterium necrophorum, a Gram-negative anaerobic organism that normally inhabits the oropharynx. Lemierre syndrome usually follows primary oropharyngeal infections and affects previously healthy adolescents and young adults in a characteristic manner, often with fatal results if left untreated. There have been a significantly increasing number of reported cases of Lemierre syndrome, possibly reflecting the trend to withhold antibiotics for initially uncomplicated oropharyngeal infections. OBJECTIVES: We hope to alert the reader to a potentially fatal disease process that has recently been increasingly identified, by reporting a unique manifestation of Lemierre syndrome, and by reviewing the current literature. CASE REPORT: A 19-year-old woman presented to our Emergency Department with a chief complaint of fever, ear pain, and generalized weakness. She was noted to be in septic shock, with left neck erythema and swelling. A computed tomography scan showed thrombosis of the left internal jugular vein (IJV), which was later excised. She recovered after a course of intravenous and oral antibiotics. CONCLUSION: Septic thrombophlebitis of the IJV is associated with multiple sources and organisms. This case is unique in both the organism (Peptococcus anaerobius) and the source (otitis externa). This disease process must be identified early and aggressively treated to avoid significant morbidity and mortality.