Lemierre's syndrome: A forgotten and re-emerging infection

Lee, Wen Sen; Jean, Shio Shin; Chen, Fu Lun; Hsieh, Szu‐Min; Hsueh, Po-Ren

doi:10.1016/j.jmii.2020.03.027

Cited by 109 publications

(116 citation statements)

References 76 publications

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“…Furthermore, brain abscesses are thought to result from retrograde intracranial extension of IJV thrombosis. 3 In our case, CT imaging identified intracranial abscess formation prior to the detection of IJV involvement, suggesting an alternative route of seeding-perhaps via the patent foramen ovale (though allowing for the possibility that IJV involvement was simply not visible on the initial CT).…”

Section: Discussionmentioning

confidence: 65%

“…2 4 9 Renal and cerebral abscess have also been reported, but are rare. 3 While the majority of cases feature pulmonary involvement, our case is unusual in that our patient presented with signs and symptoms resulting from widespread embolisation across a multitude of different organs. Furthermore, brain abscesses are thought to result from retrograde intracranial extension of IJV thrombosis.…”

Section: Discussionmentioning

confidence: 72%

“…Recommended treatment typically involves antimicrobial therapy with a beta-lactam agent and metronidazole for 3-6 weeks. 3 Where accessible, drainage of abscesses is also advised. 4 Though some articles describe respiratory failure requiring ventilation as uncommon, 4 other studies and case reports recommend involvement of the critical care team at an early stage to ensure adequate monitoring and support, with one study reporting intubation in up to 37% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…2 Reported incidence of Lemierre's syndrome has increased in recent years. [2][3][4] The increasing incidence of this previously 'forgotten' disease is thought to be due to antimicrobial stewardship efforts resulting in decreased antibiotic prescribing for upper respiratory tract infections, 3 while improving laboratory techniques may also be contributing to an increased detection rate. 4 With many countries imposing travel warnings, restrictions of movement and lockdowns during the SARS-CoV-2 pandemic, emerging data suggest a delay in patients seeking care for urgent conditions.…”

Section: Introductionmentioning

confidence: 99%

“… 2 Reported incidence of Lemierre’s syndrome has increased in recent years. 2–4 The increasing incidence of this previously ‘forgotten’ disease is thought to be due to antimicrobial stewardship efforts resulting in decreased antibiotic prescribing for upper respiratory tract infections, 3 while improving laboratory techniques may also be contributing to an increased detection rate. 4 …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminatedFusobacterium necrophoruminfection during the global COVID-19 pandemic

et al. 2020

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The SARS-CoV-2 outbreak has disrupted the delivery of routine healthcare services on a global scale. With many regions suspending the provision of non-essential healthcare services, there is a risk that patients with common treatable illnesses do not receive prompt treatment, leading to more serious and complex presentations at a later date. Lemierre’s syndrome is a potentially life-threatening and under-recognised sequela of an oropharyngeal or dental infection. It is characterised by septic embolisation of the gram-negative bacillus Fusobacterium necrophorum to a variety of different organs, most commonly to the lungs. Thrombophlebitis of the internal jugular vein is frequently identified. We describe an atypical case of Lemierre’s syndrome involving the brain, liver and lungs following a dental infection in a young male who delayed seeking dental or medical attention due to a lack of routine services and concerns about the SARS-CoV-2 outbreak.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminatedFusobacterium necrophoruminfection during the global COVID-19 pandemic

et al. 2020

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Anaerobic Gram‐Negative Bacilli

She,

Church

2023

ClinMicroNow

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The anaerobic Gram‐negative bacteria are part of the microbiota of the oral cavity, gastrointestinal tract, and urogenital tract. Many taxonomic changes have been instituted based on newer biochemical and molecular sequencing considerations. Many of the bile‐sensitive species of Gram‐negative bacilli, such as Prevotella and Porphyromonas spp. , make up a large percentage of the normal microbiota in the oral cavity and are involved in many different types of oral infections. The pigmented anaerobic Gram‐negative bacilli include members of the genera Prevotella , Porphyromonas , and Alistipes . The chapter includes a few additional Gram‐negative rods of human pathogenicity. It also helps the laboratory staff to perform all analyses, including appropriate quality control recommendations, from the receipt of the specimen (anaerobic Gram‐negative bacilli) through processing, testing, interpretation, presentation of the final report, and subsequent consultation.

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A case of blindness caused by Lemierre's syndrome

Suzuki,

Kojima,

Nakamoto

et al. 2023

Clinical Case Reports

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Key Clinical MessageWe describe a patient who lost her vision because of Lemierre's syndrome. Ophthalmologic complications of Lemierre's syndrome are rare, and very few cases have been reported. Clinicians need to recognize that it is a serious condition that can lead to blindness in some cases.AbstractLemierre's syndrome is a systemic septic embolism resulting from thrombophlebitis of the internal jugular vein. We report a case of blindness caused by Lemierre's syndrome, despite prompt diagnosis and early treatment. A 36‐year‐old woman was transported to our hospital. She presented with fever, facial swelling, and right visual acuity deterioration. Contrast‐enhanced computed tomography revealed a retropharyngeal abscess and right internal jugular vein thrombosis. Blood culture revealed Fusobacterium necrophorum, suggesting Lemierre's syndrome. The patient had septic shock and disseminated intravascular coagulation. We diagnosed her visual impairment as orbital‐apex syndrome due to spread of inflammation. After 6 weeks of antimicrobial drug treatments, her general condition had improved, and the retropharyngeal abscess had disappeared. On Day 49 of her illness, she was transferred to a rehabilitation hospital, but her visual acuity was not restored. Clinicians should be aware that Lemierre's syndrome can, although rarely, cause blindness.

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Lemierre's syndrome: A forgotten and re-emerging infection

Cited by 109 publications

References 76 publications

Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminatedFusobacterium necrophoruminfection during the global COVID-19 pandemic

Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminatedFusobacterium necrophoruminfection during the global COVID-19 pandemic

Anaerobic Gram‐Negative Bacilli

A case of blindness caused by Lemierre's syndrome

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