Lemierre Syndrome Complicating Otitis Externa: Case Report and Literature Review

Hile, Lisa M.; Gibbons, M. David; Hile, David C.

doi:10.1016/j.jemermed.2009.02.014

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…[2][3][4] We found only one prior reported case of otitis externa as the presumed source of septic thrombophlebitis of the IJV. 5 For unknown reasons, Lemierre's syndrome predominantly occurs in previously healthy, young adults at a median age of 22 years. 2 There has been a recent increase in reports of this disease in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 The most common organism implicated in Lemierre's syndrome is Fusobacterium necrophorum. [1][2][3][4][5] However, several other bacterial species such as bacteroides and eikenella have also been associated with the disease. [2][3][4] More recently, peptococcus has been implicated in this disease.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] More recently, peptococcus has been implicated in this disease. 5 There has also been recent evidence linking the Epstein-Barr virus to F necrophorum infections. 2,3 However, it remains unclear exactly how these bacteria cause septic thrombophlebitis.…”

Section: Discussionmentioning

confidence: 99%

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Lemierre's syndrome – an unusual complication of otitis externa in a young, healthy female

Davidoss

Anderson

et al. 2014

J. Laryngol. Otol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lemierre's syndrome – an unusual complication of otitis externa in a young, healthy female

Davidoss

Anderson

et al. 2014

J. Laryngol. Otol.

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“…Reported cases with the diagnosis Lemierre's syndrome/necrobacillosis including thrombosis/thrombophlebitis and sepsis are rarely due to other bacteria, although some reports could be found. Staphylococcus aureus including methicillin-resistant S. aureus [46][47][48][49][50][51], Abiotrophia defectiva [52], Arcanobacterium hemolyticum [53][54][55][56][57][58], Peptococcus anaerobius [59] and Porphyromonas asaccharolyticus [60] have been reported.…”

Section: Bacteriologymentioning

confidence: 99%

Necrobacillosis in humans

Dahlén¹,

Ebenfelt²

2011

Expert Review of Anti-infective Therapy

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Necrobacillosis, often used synonymously with Lemierre's syndrome, is a form of abscess infection in the peritonsillar area associated with a thrombophlebitis and caused by the strict anaerobic species Fusobacterium necrophorum. The thrombosis formed affects the internal jugular vein, from which the bacteria are seeded out in the bloodstream and cause bacteremia. Septicemia is a common complication with an often fatal outcome. Necrobacillosis is very rare and is referred to as the 'forgotten disease'. It is probably frequently overlooked in clinical practice in its early and milder forms such as tonsillitis (sore throat) and peritonsillar abscess. F. necrophorum frequently participates in these infections and is thus suspected to have an etiological role in Lemierre's syndrome. Similarly, F. necrophorum seems to play an important role in noma (cancrum oris) and this disease is also included in the necrobacillosis complex. Diagnosis of infections of the necrobacillosis complex seeks to disclose F. necrophorum in swab samples or blood culture. The most commonly used therapy is metronidazole in combination with penicillin or amoxicillin. Clindamycin is also an option, especially in cases of penicillin allergy.

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“…Lemierre’s syndrome (LS), also known as postanginal sepsis, is a relatively rare form of thrombophlebitis that is often missed in the early stages of infection given its predilection for previously healthy adolescents and young adults [1]. Classically, a cervicofacial infection focus with subsequent extension to the parapharyngeal space produces thrombophlebitis of the internal jugular vein, septicemia, and multiple metastatic infections, particularly involving the lungs [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Lemierre Syndrome Secondary to Community-acquired Methicillin-resistant Staphylococcus Aureus Infection Associated with Cavernous Sinus Thromboses

Stauffer

Josiah

Fortes

et al. 2013

The Journal of Emergency Medicine

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Background Lemierre’s Syndrome (LS) is a highly aggressive rare disease process with a predilection for young, healthy adolescents. Often beginning with a primary cervicofacial infection, LS rapidly progresses to thrombophlebitis of the cerebral vasculature, metastatic infection, and septicemia. Untreated LS can be rapidly fatal. Thrombus within the cerebral vasculature can have devastating neurological effects. Advances in antibacterial therapy have resulted in a global decline in the incidence of LS, and clinicians may not consider LS early in the disease process. While the mortality of LS has declined, the morbidity associated with the disease has increased, particularly the neurological sequelae. Objectives This report will provide readers with a better understanding of the etiology, clinical presentation, evaluation methods, and appropriate treatment of LS. Case Report We present an atypical case of LS secondary to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection progressing to bilateral cavernous sinus and ophthalmic vein thromboses with resultant binocular vision loss secondary to optic nerve and retinal ischemia. Conclusion This case highlights the importance of early recognition of LS in the setting of a community-acquired MRSA infection as the unifying condition in a young patient with multiple acute neurologic impairments.

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Lemierre Syndrome Complicating Otitis Externa: Case Report and Literature Review

Cited by 17 publications

References 14 publications

Lemierre's syndrome – an unusual complication of otitis externa in a young, healthy female

Lemierre's syndrome – an unusual complication of otitis externa in a young, healthy female

Necrobacillosis in humans

Lemierre Syndrome Secondary to Community-acquired Methicillin-resistant Staphylococcus Aureus Infection Associated with Cavernous Sinus Thromboses

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