Lemierre’s disease: a case with bilateral iliopsoas abscesses and a literature review

Abstract

Lemierre’s disease is characterized by sepsis, often with an oropharyngeal source, secondary septic emboli and internal jugular vein thrombosis (Lancet 1:701–3, 1936. Clin Microbiol Rev 20(4):622–59, 2007). Septic emboli affecting many bodily sites have been reported, including the lungs, joints, bones, and brain. The case report describes an unusual case of Lemierre’s disease in a 64 year old gentleman causing profound sepsis, acute kidney injury, bilateral iliopsoas abscesses and a right hand abscess. To our knowledge, this is the first reported case of Lemierre’s disease in the context of bilateral psoas abscesses, and highlights the ambiguity surrounding the definition of Lemierre’s disease. The clinical literature review highlights the difficulty in definitively diagnosing the condition and offers some suggestions for recognising and refining the diagnostic criterion of Lemierre’s.

Fusobacterial head and neck infections in children

“…can be recovered from dental [33] parapharyngeal, retropharyngeal, [42,85] peritonsillar, [41] intracranial, [79,81] visceral, hepatic, [86] splenic, [86] subphrenic, [87] perirectal, [88] pilonidal, [89] pelvic, illeopsoas [90], and vulvovaginal abscesses [27]. Fusobacterial abscesses in the soft tissue of the limbs, breasts, lungs, and parotid gland have been reported.…”

Detection of mecA and 16S rRNA Genes Using Real‐Time PCR Can Be Useful in Diagnosing Iliopsoas Abscess, Especially in Culture‐Negative Cases: RT‐PCR for Iliopsoas Abscess

“…Iliopsoas abscess is a relatively rare disorder that has a diversity of frequency depending on patients' race, gender, and preexisting diseases [1]. Sequential iliopsoas abscess has been reported in the immunological suppression in rheumatoid arthritis, cervical spondylosis infection, ulcerative colitis, malignant tumor cases, and cardiovascular disorders [22][23][24][25][26]. Our study demonstrated that undernutrition is an indicator for the possible presence of IPA; however, serum inflammatory markers may not be useful to differentiate IPA from other inflammatory responses.…”

Internal jugular vein thrombosis associated withGranulicatella adiacens

“… 2 In addition, metastasis of soft tissues has been reported, including bilateral psoas abscesses. 5 In our case, the pulmonary embolism and gluteal muscle abscesses could be considered as metastasis from IJV thrombosis.…”

“…2 In addition, metastasis of soft tissues has been reported, including bilateral psoas abscesses. 5 In our case, the pulmonary embolism and gluteal muscle abscesses could be considered as metastasis from IJV thrombosis. Empirical treatment for jugular vein suppurative thrombophlebitis should include a beta-lactam with a beta-lactamase inhibitor and an antibiotic with good anaerobic coverage.…”