Lemierre syndrome: Two cases and a review

被引:83
作者
Syed, Mohammed Lqbal [1 ]
Baring, David
Addidle, Michael
Murray, Craig
Adams, Calum
机构
[1] Royal Alexandra Hosp, Dept Otolaryngol, Paisley PA2 9PN, Renfrew, Scotland
[2] Clyde NHS Trust, Paisley PA2 9PN, Renfrew, Scotland
[3] Royal Alexandra Hosp, Dept Microbiol, Paisley PA2 9PN, Renfrew, Scotland
[4] Royal Alexandra Hosp, Dept Radiol, Paisley PA2 9PN, Renfrew, Scotland
关键词
oropharyngeal infection; Fusobacterium necrophorum; internal jugular vein thrombosis; cranial nerve complications; neurological complications;
D O I
10.1097/MLG.0b013e318093ee0e
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives: Lemierre syndrome is usually caused by an acute oropharyngeal infection in previously healthy young adults, resulting in thrombophlebitis of the internal jugular vein, leading to metastatic septic embolization and bacteraemia. The usual organism is Fusobacterium necrophorum. Lemierre syndrome, not so long ago labeled as the "forgotten disease," is on the rise. Today with increasing antibiotic-resistant organisms, and decreasing awareness of the syndrome, subsequent re-emergence of this "forgotten disease" is becoming more common in clinical settings. Lemierre syndrome has significant morbidity. Cranial nerve complications associated with the condition have been increasingly diagnosed in the last few years. Looking back at literature on Lemierre syndrome, there have been review articles in medical and microbiology journals but rarely in otolaryngology journals. By presenting our cases we demonstrate the diverse presentations and severity of the illness. Methods: A review of the literature and a case report on two cases seen in our institution in the last year are presented. Each of these had varied presentations and neurologic complications-one developed 9th to 12th cranial nerve palsies and Horner syndrome, which have not been described in previous literature, and the other developed polyneuropathy and a frontal lobe infarct among other multisystem complications. Conclusions: Diagnosis of Lemierre syndrome is not always straightforward as clinical features are variable and blood cultures are often negative. Awareness of the syndrome and a high degree of suspicion are needed.
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收藏
页码:1605 / 1610
页数:6
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