A Case of Lemierreʼs Syndrome Due to Klebsiella pneumoniae

Bhagat, Bipinchandra; Ahmed, Monjur; Ali, Sana; Roistacher, Kenneth

doi:10.1097/00019048-199608000-00010

Cited by 4 publications

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“…Involvement of K. pneumoniae in the causation of LS is rare, with only two previously reported cases [ 11 , 12 ] both of whom were also diabetic; therefore the question arose as to whether diabetes mellitus (DM) had a role in selecting this organism, or it was a mere coincidence? This association has been reported previously by Huang et al [ 13 ], where 98.4% of their patients with diabetes had infections due to K. pneumoniae .…”

Section: Discussionmentioning

confidence: 99%

Lemierre's syndrome due to Klebsiella pneumoniae in a 63-year-old man with diabetes: a case report

2012

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IntroductionLemierre's syndrome was originally documented to be caused by Fusobacterium necrophorum. It is a very rare condition with a prevalence of one to 14.4 instances per million. Its presentation is varied, not only in composition but also in the infecting organism. Treatment with anticoagulants has been controversial and applied only on a case-by-case basis.Case presentationA 63-year-old Saudi man who had had uncontrolled diabetes mellitus for 47 years presented to our facility with a five-day history of swelling on the right side of his neck and fever. The swelling progressively increased in size and was associated with pain, dysphagia, odynophagia, change of voice ('hot potato voice'), and reduced appetite. Abscess content culture and sensitivity testing revealed Klebsiella pneumoniae. However, blood culture results were repeatedly negative. The abscess was incised and drained without any complication. Our patient was treated with clindamycin and cefuroxime. Warfarin was also administered concurrently for six weeks, for an isolated internal jugular vein thrombosis (IJV), with complete resolution of the thrombus. Normoglycemia was achieved and our patient was discharged after complete wound healing and the return of his biochemical parameters to normal.ConclusionsOnly two cases of Lemierre's syndrome in patients with diabetes due to K. pneumoniae have been reported previously. A review of the literature suggested that an association exists between deep neck infections due to K. pneumoniae and diabetes mellitus. The reasons for this association are still not clear. This poses a question as to whether diabetes mellitus specifically predisposes these patients to infection with this organism. It is suggested that clinicians should consider infectious agents other than F. necrophorum in the causation of Lemierre's syndrome, especially in patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

Lemierre's syndrome due to Klebsiella pneumoniae in a 63-year-old man with diabetes: a case report

2012

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Lemierre syndrome due to Klebsiella pneumoniae: a rare case report with review of literature

Rangan,

Singh,

Yadav

et al. 2024

J Rare Dis

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Lemierre’s syndrome, a forgotten clinical entity, is characterised by septic thrombophlebitis of the internal jugular vein due to oropharyngeal infection. In the past, it was mainly associated with Fusobacterium necrophorum infections. We present a unique case report of Lemierre’s syndrome due to Klebsiella pneumoniae. Patient reported with progressive swelling involving right side of the neck that eventually increased in size. After confirming the diagnosis through CECT, patient was managed through combined medical and surgical therapy in the form of incision and drainage, targeted antibiotic therapy, glycaemic control and anticoagulation therapy. This case report highlights the association of poor glycaemic control in the pathogenesis and the isolation of Klebsiella pneumoniae as the rare organism of Lemierre’s syndrome.

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Lemierre syndrome caused by Klebsiella pneumoniae complicated by epidural abscess – Case report

Sabaka

Kachlíková

Bendžala

et al. 2020

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A Case of Lemierreʼs Syndrome Due to Klebsiella pneumoniae

Cited by 4 publications

References 0 publications

Lemierre's syndrome due to Klebsiella pneumoniae in a 63-year-old man with diabetes: a case report

Lemierre's syndrome due to Klebsiella pneumoniae in a 63-year-old man with diabetes: a case report

Lemierre syndrome due to Klebsiella pneumoniae: a rare case report with review of literature

Lemierre syndrome caused by Klebsiella pneumoniae complicated by epidural abscess – Case report

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