A Case of Lemierre Syndrome Secondary to Otitis Media and Mastoiditis

Abstract

Lemierre's syndrome is a rare clinical condition that generally develops secondary to oropharyngeal infection caused by Fusobacterium necrophorum, which is an anaerobic bacteria. A 62-year-old patient with diabetes mellitus presented with internal jugular vein and sigmoid sinus-transverse sinus thrombophlebitis, accompanying otitis media and mastoiditis that developed after an upper airway infection. Interestingly, there were air bubbles in both the internal jugular vein and transverse sinus. Vancomycin and meropenem were started and a right radical mastoidectomy was performed. The patient's clinical picture completely resolved in 14 days. High mortality and morbidity may be prevented with a prompt diagnosis of Lemierre's syndrome.

Malignant otitis externa with subsequent internal jugular vein thrombosis and hypoglossal palsy: a report and review of literature

“…Though the radio-isotope scans repeated during this episode and while on follow up would have been conclusive in this regard, unfortunately we couldn’t do it in our case. The other possibility to consider in our case is acute otitis media or acute mastoiditis complicating as thrombosis of sigmoid sinus and IJV thrombosis ( Davidoss et al., 2015 ; Turan et al., 2014 ). However, when the mastoid was explored, the middle ear inflammation was not significant and there was no involvement of the sinus plate.…”

“…The IJV thrombosis in MOE by itself has been reported sparsely and very rarely has this been attributed to parapharyngeal space involvement ( Kornilenko et al., 2017 ; Low and Lhu, 2018 ; Kornilenko et al., 2017 ; Davidoss et al., 2015 ; Turan et al., 2014 ). On the other hand, though many authors have reported a non-predictable spread of the MOE to involve non-contagious sites belonging to separate compartments causing VI, VII, IX, X, XI, XII nerve palsies in various combinations very rarely these deficits have been thought to be due to parapharyngeal space involvement.…”

An unusual cause of sore throat and neck swelling

“…The disease most commonly manifests with sore throat, fever, chills, shivering and unilateral neck pain and swelling in young, healthy individuals. The diagnosis of LS is made by Doppler ultrasound or contrast CT and blood culture in addition to clinical suspicion 2. LS is treated with antibiotics effective against anaerobes and Gram-negative bacteria.…”