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Query: UMLS:C0343525 (Lemierre's syndrome)
443 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of Lemierre syndrome characterized by thrombophlebitis of the internal jugular vein with multiple metastatic foci after acute otopharyngeal infection in a 30-year-old woman. Despite treatment with tonsillectomy leading to a diagnosis of peritonsillar abscess, her condition worsened and she was admitted with high fever. Chest radiograph and CT scan of the thorax revealed multiple pulmonary cavities and pleural effusion on the right side. On neck CT, a thrombus was detected in the left internal jugular vein. She received with intravenous clindamycin (CLDM) and cefepime (CFPM) and progressively improved. Although Lemierre syndrome is a relatively uncommon disease with the potentially life-threatening complication of acute pharyngotonsillitis, this syndrome should be considered in cases of severe tonsillitis or pharyngitis.
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PMID:[A case of Lemierre syndrome]. 1453 1

Lemierre's syndrome is characterized by acute oropharyngeal infection complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and metastatic abscesses. We report a case of Lemierre's syndrome in an 18-year-old Caucasian woman presenting with a peritonsillar abscess and ipsilateral VIth cranial nerve palsy.
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PMID:Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. 1677 58

Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections. The authors present an unusual case of Lemierre syndrome in a 16-year-old boy with cavernous sinus thrombosis and right internal carotid artery narrowing without neurological sequelae, right subdural empyema, and cerebritis in the right temporal and occipital lobes. Neuroimaging also demonstrated right jugular vein thrombosis. Cultures of samples from the blood proved positive for the presence of Fusobacterium necrophorum. The patient underwent unilateral tonsillectomy, drainage of the peritonsillar abscess, and a myringotomy on the right side. Postoperatively the patient was treated conservatively with antibiotic therapy resulting in an excellent outcome.
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PMID:Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction. Case report. 1723 14

A 38-year-old homeless man was admitted with a 2-week history of a sore throat, increasing shortness of breath, and high fever. Clinical examination showed enlarged and tender submandibular and anterior cervical lymph nodes and a pronounced enlargement of the left peritonsillar region (Figure 1a). CT scan of the throat and the chest showed left peritonsillar abscess formation, occlusion of the left internal jugular vein with inflammatory wall thickening and perijugular soft tissue infiltration, pulmonary abscesses, and bilateral pleural effusions (Figures 1b-e, arrowed). Anaerobe blood cultures grew Fusobacterium necrophorum, leading to the diagnosis of Lemierre's syndrome. Treatment with high-dose amoxicillin and clavulanic acid improved the oropharyngeal condition, but the patient's general status declined further, marked by dyspnea and tachypnea. Repeated CT scans showed progressive lung abscesses and bilateral pleural empyema. Bilateral tonsillectomy, ligation of the left internal jugular vein, and staged decortication of bilateral empyema were performed. Total antibiotic therapy duration was 9 weeks, including a change to peroral clindamycin. Clinical and laboratory findings had returned to normal 12 weeks after surgery.The patient's history and the clinical and radiological findings are characteristic for Lemierre's syndrome. CT scans of the neck and the chest are the diagnostic methods of choice. F. necrophorum is found in over 80% of cases of Lemierre's syndrome and confirms the diagnosis. Prolonged antibiotic therapy is usually sufficient, but in selected patients, a surgical intervention may be necessary. Reported mortality rates are high, but in surviving patients, the recovery of pulmonary function is usually good.
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PMID:Advanced Lemierre syndrome requiring surgery. 1879 36

Lemierre's syndrome is a rare but a life threatening condition which affects young healthy individuals, was first described by Dr.Andre Lemierre in 1936. Incidence rates are between 0.6 and 2.3 per million population. It is found more commonly in males, with a male to female ratio of approximately 2:1. Its pathogenesis consists of the development of infectious thrombophlebitis in the internal jugular vein or one of its branches caused by a focal sepsis, mostly localized in the oropharynx, leading to generalized multiorgan metastatic infections, generally to the lung. This computerized tomography (CT) neck with intravenous contrast is from a 24 year old female who presented with a two day history of fever, hypotension and respiratory failure. The physical exam was positive for diminished breath sounds bilaterally on lung exam. Complete blood count revealed a leukocytosis of 16,200 u/L with 70% neutrophils and 9% bands, hemoglobin of 13.4mg/dl and severe thrombocytopenia with a platelet count of 34,000 u/L; comprehensive metabolic panel revealed sodium 140mmol/L, potassium 2.9mmol/L, bicarbonate 26mmol/L, blood urea nitrogen (BUN) 16mg/dl, creatinine 0.8mg/dl, calcium 7.2 mg/dl, albumin 2.4g/dl, total bilurubin 3.1mg/dl, AST 81 U/L, ALK 101 U/L, ALT 35U/L. CT chest revealed multiple cavitary opacities in both lungs. Blood cultures were positive for Fusobacterium necrophorum. CT scan neck showed a filling defect of the right internal jugular vein consistent with a thrombus and multiple enlarged cervical lymph nodes. Treatment is medical with intravenous antibiotics and anticoagulation. References: 1. Carlson ER, Bergamo DF, Coccia CT. Lemierre's syndrome: two cases of a forgotten disease. J Oral Maxillofac Surg 1994; 52:74-78. 2. Moore-Gillon J, Lee TH, Eykyn SJ, Phillips I. Necrobacillosis: a forgotten disease. BMJ 1984;288:1526-1527. 3. Jones C, Siva TM, Seymour FK, O'Reilly BJ. Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. J Laryngol Otol 2006;120:502-504 4. Mohammed Iqbal Syed et al. Lemierre Syndrome: Two Cases and a Review. Laryngoscope, 117:1605-1610, 2007 5. Vohra A, Saiz E, Ratzan KR. A young woman with a sore throat, septicaemia, and respiratory failure. Lancet 1997; 350:928.
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PMID:"A forgotten disease": a case of Lemierre syndrome. 1946 52

Septic thrombophlebitis caused by head and neck infection has become a rare disorder due to the development of antibiotics. We report herein two cases of septic thrombophlebitis of the head and neck. Case 1 was a 7-year-old girl, who presented with fever, otalgia, and headache. Acute otitis media was diagnosed in another hospital. A computed tomography (CT) scan and magnetic resonance imaging (MRI) demonstrated mastoiditis with thrombophlebitis of the right lateral and sigmoid sinuses. Case 2 was a 39-year-old woman, who presented with left neck pain, fever chills and severe pharyngalacia. Peritonsillar abscess was diagnosed. A CT scan demonstrated a left internal jugular vein thrombus in addition to multiple pulmonary nodules with emboli. A diagnosis of Lemierre's syndrome was made based on these findings. Both cases were successfully treated by intravenous antibiotics. A lack of awareness of these conditions and a delayed diagnosis may lead to potentially fatal consequences. A clinical suspicion of septic thrombophlebitis seems to be essential to make an accurate diagnosis during the early stage of the disease and archive a successful outcome.
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PMID:Thrombophlebitis of the head and neck: report of two cases. 2018 29

Lemierre's syndrome is a severe complication of Fusobacterium necrophorum oropharyngeal infection associated with metastatic foci of infection, internal jugular vein thrombosis, and septicemia. Musculoskeletal manifestations include isolated or multifocal septic arthritis, soft tissue abscesses, pyomyositis, and osteomyelitis. This article describes a case of a variant of Lemierre's syndrome in a 17-year-old girl, demonstrating a relentless case of limb infection refractory to multiple surgical debridements and broad-spectrum and targeted antibiotics. The patient had F. necrophorum within a peritonsillar abscess and multiple foci within her right lower extremity. Overall, she required 12 surgical procedures and 14 weeks of antibiotic therapy to resolve the infection. Further unique findings in this case include the presence of a recent lateral meniscus tear with associated hemarthrosis treated with a short course of oral steroids prior to the diagnosis of septic arthritis. Knee arthroscopy with lysis of adhesions and manipulation at 6 months postinfection demonstrated significant chondral damage. Outcome at >2-year follow-up revealed pain-free activities of daily living and the ability to return to competitive, club-level collegiate softball. Clinically relevant findings illustrated in this case include potential development of antibiotic resistance within Fusobacterium genus with little to no response to several surgical debridements and broad-spectrum and targeted antibiotics, and development of multifocal, ipsilateral septic arthritis and soft tissue abscesses and pyomyositis in the context of steroid use and recent intra-articular knee injury.
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PMID:Severe musculoskeletal infection variant in Lemierre's syndrome. 2095 54

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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PMID:Necrobacillosis in humans. 2134 70

Lemierre's syndrome is a rare but serious condition, characterized by disseminated infection with Fusobacterium necrophorum, most often originating from the oropharynx. Thrombophlebitis of the internal jugular vein and septic embolisms to various organs is the typical clinical picture. We describe a 16-year-old man with peritonsillar abscess who developed abscesses in lungs, liver and spleen. The patient was admitted to the ICU and treated with surgical drainage of infectious foci, antibiotics and anticoagulant therapy. After six weeks of antibiotic treatment the patient was discharged with no sequelae.
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PMID:[Lemierre's syndrome following peritonsillar abscess]. 2266 50

Lemierre's syndrome is only very rarely caused by Porphyromonas asaccharolytica. Here, we report the case of a 35-year-old man who developed a left peritonsillar abscess, thrombophlebitis of the left internal jugular vein, and septic embolization of both lungs. Anaerobic P. asaccharolytica was isolated in the blood cultures, and we subsequently confirmed the diagnosis as Lemierre's syndrome. Our case indicates that although P. asaccharolytica is not commonly found in oral cavities, this organism may still cause Lemierre's syndrome. Consequently, when it is detected in blood cultures, the treating physician should perform the medical examination while keeping in mind the possibility that the patient could have Lemierre's syndrome.
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PMID:A rare case of Lemierre`s syndrome caused by Porphyromonas asaccharolytica. 2343 19


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