<p>Lemierre Syndrome. A Forgotten Disease. Case Report and Review of Literature</p>

Abstract

IntroductionLemierre syndrome is a serious condition that associates oropharyngeal infection and thrombosis of the internal jugular vein (IJV) with subsequent distant septic emboli, most frequently in the lungs.Case presentationA 70-year-old female with retropharyngeal abscess developed features of Lemierre syndrome. The condition was managed with serial aspiration of the abscess and prolonged usage of intravenous antibiotics.DiscussionLemierre syndrome is most frequently caused by the anaerobic bacterium, Fusobacterium necrophorum. Although rare, there is evidence of a resurgence in the condition in recent years, most probably due to reduced use of antibiotic therapy for sore throats. Although there is a characteristic clinical picture, many clinicians are unaware of this condition, leading to delayed diagnosis with potentially fatal consequences.ConclusionEarly diagnosis of this condition and prompt treatment with intravenous broad spectrum antibiotics results in a complete resolution of this condition. Surgery is indicated in the case of abscess formation.

Anticoagulation Strategies in the Management of Lemierre Syndrome: A Systematic Review of the Literature

“…Significant neck pain, with or without other constitutional symptoms, was described in every patient with an IJV thrombosis. 16-25,27,28 This lends credence to the notion that LS should be readily included in the differential diagnosis of pharyngitis, tonsillitis, and other infections of the oral cavity. 11 An additional evaluation of the clinical presentation of the patients included in this evaluation revealed the presence of pulmonary implications, specifically rales, wheezing, and dyspnea.…”

“…It is important to note that every case report initially began anticoagulation with an intravenous or subcutaneous medication, such as heparin, enoxaparin, or fondaparinux, though only 2 reports detailed a transition to a direct-acting oral anticoagulant (DOAC) as opposed to an outpatient regimen of enoxaparin or warfarin therapy. [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Although difficult to ascertain definitive treatment regimens from the limited data available, several important distinctions can be gleaned with regard to patient presentation and the duration of anticoagulation therapy. Significant neck pain, with or without other constitutional symptoms, was described in every patient with an IJV thrombosis.…”

Fusobacterium necrophorum Septicemia Leading to Lemierre’s Syndrome in an Immunocompetent Individual: A Case Report

“…Hallmark for diagnosis is presence of thrombophlebitis of the IJV with blood cultures usually growing Fusobacterium necrophorum [4]. Other organisms isolated in Lemierre disease include Streptococcus species, Bacteroides species, Peptostreptococcus species and Eikenella corrodens [5].…”

Lemierre’s disease: a typical presentation in two diabetic patients

“…In recent times many cases have been reported in the middle age and elderly individuals with pre-existing immunocompromised conditions such as diabetes mellitus, cancer etc. 5,6 The lung is considered to be the most common site of septic emboli followed by other organs such as liver, spleen, joints, heart and central nervous system. [10][11][12][13][14][15][16][17] Involvement of clivus and cranial nerves in LD is infrequent.…”

“…1,3 In recent times many cases of LD have been reported in the middle aged and elderly group of patients. [4][5][6] The possible causes include increase in comorbidities such as diabetes, use of immunosuppressive drugs and prevalence of drug resistance bacteria. 7 In this article, we present two such interesting cases of LD in diabetic patients with atypical presentations with a review of the literature.…”