An atypical presentation of lemierre syndrome of urogenital source

Abstract

Lemierre syndrome has classically been described as septic thrombophlebitis of the internal jugular veins resulting from primary oropharyngeal disease caused by Fusobacterium necrophorum. However, many cases have been reported of the syndrome originating from other primary sites of infection, resulting in limited utility of the diagnostic criteria and increased difficulty in making the diagnosis. We describe a 22-year-old female who developed the syndrome through a Fusobacterium infection which originated from a Bartholin gland abscess, a phenomenon that has not yet been described in the literature. Understanding and recognizing the variable forms of Lemierre syndrome allows us to better define the condition and provide optimal care to patients.

Complex Lemierre syndrome with multisystemic abscesses

“…Abdominal symptoms have been commonly reported in patients with typical Lemierre syndrome initiated by a pharyngeal infection 2 5. However, primary infection sites can be found in the liver and be associated with portal vein thrombosis (pylephlebitis),8–10 or in gynaecological organs such as the vagina, cervix and uterus (with or without intrauterine device) and be associated with pelvic veins thrombosis 11–16. Although not specific, thrombocytopaenia, as observed in the present case, is a common feature of Lemierre syndrome 2 5.…”