Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0343525 (Lemierre's syndrome)
 443 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lemierre syndrome (postanginal septicemia) is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. A high degree of clinical suspicion is necessary for diagnosis. Fusobacterium necrophorum is the usual etiologic agent. The disease progresses in several steps. The first stage is the primary infection, which is usually a pharyngitis (87.1% of cases). This is followed by local invasion of the lateral pharyngeal space and IJV septic thrombophlebitis (documented in 71.5% of cases), and finally, the occurrence of metastatic complications (present in 90% of cases at the time of diagnosis). A sore throat is the most common symptom during the primary infection (82.5% of cases). During invasion of the lateral pharyngeal space and IJV septic thrombophlebitis, a swollen and/or tender neck is the most common finding (52.2% of patients) and should be considered a red flag in patients with current or recent pharyngitis. The most common site of metastatic infection is the lungs (79.8% of cases). In contrast to the preantibiotic era, cavitating pneumonia and septic arthritis are now uncommon. Most patients (82.5%) had fever at some stage during the course of the disease. Gastrointestinal complaints such as abdominal pain, nausea, and vomiting were common (49.5% of cases). An elevated white blood cell count occurred in 75.2% of cases. Hyperbilirubinemia with slight elevation of liver enzyme levels occurred in one-third of patients, but frank jaundice was uncommon, in contrast to its high frequency reported in the preantibiotic era. We conclude that, most likely as a consequence of widespread antibiotic use for pharyngeal infections, the typical course of the disease has changed since Lemierre's original description. The typical triad in our series was: pharyngitis, a tender/swollen neck, and noncavitating pulmonary infiltrates. The previous classical description of severe sepsis with cavitating pneumonia and septic arthritis was not commonly seen in our review. Mortality was low in our series (6.4%), but significant morbidity occurred, which was likely preventable by early diagnosis and treatment. The pathophysiology, natural history, diagnostic methods for internal jugular vein thrombosis, and management are discussed.
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PMID:The evolution of Lemierre syndrome: report of 2 cases and review of the literature. 1244 2

Fusobacterium necrophorum infections are rare. We report a 15-year-old male who presented with tachycardia, nausea, vomiting, diarrhoea and ankle pain. He rapidly deteriorated requiring ventilation and vasopressors. Imaging of his thorax showed airspace consolidation, pulmonary cavitations and empyema. The ankle required drainage of purulent material. A thrombus in his internal jugular vein (Lemierre's syndrome) and an abscess in his obturator internus were subsequently found. Fusobacterium necrophorum was identified in blood culture on day nine. The patient recovered with antibiotics and surgical interventions for empyema and septic arthritis. Fusobacterium necrophorum should be a suspected pathogen in septic shock complicated by metastatic abscess formation.
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PMID:Lemierre's syndrome with septic shock caused by Fusobacterium necrophorum. 1793 73

An 18-year-old male was admitted to the Accident & Emergency department with complaints of abdominal pain, vomiting and diarrhoea. He was clinically jaundiced and further CT scan suggested liver abscess. Later on blood cultures showed gram-negative bacilli and a further liver aspirate culture confirmed the presence of the rare Fusobacterium necrophorum. A diagnosis of hepatic abscess secondary to Lemierre's syndrome was made and patient was treated with appropriate antibiotics. Lemierre's syndrome, although a rare condition, may be associated with serious life-threatening complications. Early recognition and treatment is essential in successfully treating this rare condition. A review of Lemierre's syndrome is presented. We recommend clinicians to be aware of this condition (Lemierre's Syndrome) especially when dealing with young patients with sore throat and jaundice. It is important for primary care physicians to be aware of this condition as they are discouraged from prescribing antibiotics for young patients with sore throat. Although it is a rare condition, it is associated with severe life threatening complication like liver abscesses.
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PMID:Lemierre's syndrome secondary to Fusobacterium necrophorum infection, a rare cause of hepatic abscess. 2016 40

We report a case of a previously healthy 33-year-old male who presented to his primary care physician with nausea, vomiting, diarrhoea and fever. One week prior to presentation the patient reported a history of sore throat which he presumed to be a viral infection and sought no medical attention. Upon hospital presentation, the patient was admitted and rapidly progressed to sepsis and respiratory failure. Goal directed therapy was initiated and the patient was intubated. Further clinical work up included blood cultures revealing Fusobacterium varium bacteraemia, and CT and ultrasound imaging demonstrated thrombosis of the internal jugular vein and septic pulmonary emboli. A diagnosis of Lemierre syndrome was made, and antibiotics as well as anticoagulation therapy were initiated. The patient's clinical condition improved with treatment, and he was discharged home on hospital day 12 with completion of an uneventful 4-week course of outpatient antibiotic and anticoagulation therapy.
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PMID:Lemierre syndrome: from pharyngitis to fulminant sepsis. 2279 14

A 17 year old male presented with seizures, headache, and fever and left chronic suppurative otitis media. A 35 year old male presented with headache, giddiness, vomiting, pain in eyes, diplopia and right chronic suppurative otitis media. Brain imaging in both revealed thrombosis of lateral and sigmoid sinus and also of internal jugular vein on the left and right side respectively. A diagnosis of Lemierre's syndrome was made in both. They were treated with antibiotics and anticoagulants, and they responded to treatment. We want to report this case as we feel, that with the advent of the antibiotic era, this syndrome has become rare; and so "quite forgotten" or overlooked, by many physicians.
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PMID:Lemierre's syndrome--the syndrome quite forgotten. 2279 22

Fusobacteria belong to the normal population of the pharyngeal mucosa as well as the mucosa of the upper airways and the gastrointestinal tract. Infections are comparatively rare. The most common causative organism is Fusobacterium necrophorum. A well-known infection caused by this germ is Lemierre's syndrome. In the presented case, a 19-year-old man (123 kg body weight, 186 cm body length) was found dead in his bed in the morning after having complained of muscular fatigue and vomiting the previous day. Autopsy was carried out only two days after death. At that time, the body showed marked putrefaction with partial greenish discoloration and marbling of the skin although it had been stored in a refrigerator at +2 degrees C in the meantime. While the autopsy itself revealed no cause of death, microbiological examination of a smear from the left lower pulmonary lobe demonstrated Staphylococcus aureus and Fusobacterium necrophorum. Toxicological investigations produced negative results throughout. The cause of death was defined as sepsis caused by Fusobacterium necrophorum.
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PMID:[Sepsis due to fusobacteria in a young adult]. 2738 22