Lemierre Syndrome Complicating Deep Neck Infection and Descending Mediastinitis Secondary to Methicillin resistant Staphylococcus aureus (MRSA) Infection

Al‐Hebshi, Abdulqader; Alharbi, Hind; Karbouji, Rayan; Qurainees, Ghaya Al; Alkurdi, Ahmad

doi:10.12669/pjms.38.5.5442

Cited by 2 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 11 ] The primary infection varied widely, including 5 cases of neck abscess [ 13 , 14 , 18 ] and 3 cases of neck cellulitis, [ 11 , 16 ] as in our case. Staphylococcus aureus was the most reported pathogen, including 6 cases of MRSA, [ 10 , 14 , 15 , 17 , 19 ] 2 MSSA, [ 1 , 13 ] and 1 S. aureus with an unknown resistance profile, [ 18 ] followed by Klebsiella pneumoniae in 2 cases. [ 11 , 18 ] All the patients received different combinations of antimicrobial therapies.…”

Section: Discussionmentioning

confidence: 99%

“…Vancomycin, Piperacilin/Tazobactam, Clindamycin Heparin Recovered Herek et al [15] USA 33 F Several hours Marked face and neck swelling, a perioral rash, dyspnea, and hoarseness.…”

Section: Inmuno-competentmentioning

confidence: 99%

“…Eleven patients had secondary soft tissue infection, 1,10,11,13,14,[16][17][18][19] while the other 2 cases were secondary to osteomyelitis [12] and oral ulcers. [15] Their ages varied between 5 and 74 years. Almost half of the patients were male.…”

Section: Recoveredmentioning

confidence: 99%

See 2 more Smart Citations

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review

Carreras,

Salcedo,

Ponce-Rosas

et al. 2024

Medicine

View full text Add to dashboard Cite

Rationale: Lemierre-like syndrome (LLS) is characterized by bacteremia, septic thrombophlebitis of the internal jugular vein, and metastatic abscesses. In contrast to classic Lemierre syndrome, sources of infection are not related to oropharyngeal infections, as are frequent soft tissue infections. In recent years, Staphylococcus aureus has been identified as an emergent pathogen that causes this syndrome. The mortality rate of LLS caused by this pathogen is approximately 16%. Timely diagnosis, antibiotic treatment, and infection control are the cornerstones to treat LLS. Anticoagulant therapy as adjuvant treatment remains controversial. Patient concerns: A 31-year-old woman from California, United States (US), was admitted to the emergency room with a history of 2 days of fever and severe throbbing pain in the left cervical region. Thorax and neck CT tomography revealed confluent cavities suggestive of septic embolism in the lungs and a filiform thrombus in the lumen of the left internal jugular vein, with moderate swelling of the soft and muscular tissues. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the blood culture. Diagnosis: The thrombus in the internal jugular vein associated with cellulitis in the neck and multiple cavitary lesions in the lungs support the diagnosis of LLS caused by MRSA with septic embolization. Interventions: During treatment, the patient received vancomycin IV for 25 days and returned to the US with linezolid orally. In addition, assisted video-thoracoscopy and bilateral mini-thoracotomy with pleural decortication were performed for infectious source control, where 1700cc of purulent pleural fluid was drained. Outcomes: The patient was discharged with optimal evolution. Lessons: LLS should be suspected in patients with skin and soft tissue infections who develop thrombosis or metastatic infections. MRSA infections should be considered in patients from areas where this pathogen is prevalent.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Vancomycin, Piperacilin/Tazobactam, Clindamycin Heparin Recovered Herek et al [15] USA 33 F Several hours Marked face and neck swelling, a perioral rash, dyspnea, and hoarseness.…”

Section: Inmuno-competentmentioning

confidence: 99%

See 1 more Smart Citation

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review

Carreras,

Salcedo,

Ponce-Rosas

et al. 2024

Medicine

View full text Add to dashboard Cite

show abstract

Descending necrotising mediastinitis: a rare entity in children

Marques,

Rato,

Miguéis

et al. 2024

BMJ Case Rep

View full text Add to dashboard Cite

We present a case of descending necrotising mediastinitis (DNM) originating from a retropharyngeal abscess in a healthy early childhood patient. The patient had a history of fever, odynophagia and refusal to eat, followed by rapid deterioration of the clinical state. Cervicothoracic CT was performed, which revealed a right parapharyngeal abscess, extending to the mediastinum and occupying the retropharyngeal/visceral space, with gaseous content throughout this collection, associated with bilateral pleural effusion, aspects compatible with DNM. She started broad-spectrum antibiotic therapy and transoral drainage of the parapharyngeal and retropharyngeal collections was performed under general anaesthesia. She was admitted to the intensive care unit. The patient showed clinical, analytical and imaging improvement, having been transferred to the ear, nose and throat department, with favourable evolution. Early diagnosis of DNM by cervicothoracic CT and multidisciplinary approaches, including intensive care, broad-spectrum antibiotics and surgical intervention, are crucial to minimise the morbidity and mortality.

show abstract

Lemierre Syndrome Complicating Deep Neck Infection and Descending Mediastinitis Secondary to Methicillin resistant Staphylococcus aureus (MRSA) Infection

Cited by 2 publications

References 16 publications

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review

Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review

Descending necrotising mediastinitis: a rare entity in children

Contact Info

Product

Resources

About