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Lemierre Syndrome

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181. A vanishing disease can still happen. (Abstract)

A vanishing disease can still happen. Lemierre's syndrome is a rare disease in the antibiotic era which is characterised by oropharyngitis, thrombophlebitis and septic metastases, but it can still occur and early recognition of its characteristic features and commencement of appropriate treatment can be life saving. The case history is described of a middle-aged man with Lemierre's syndrome who made an uneventful recovery following treatment with co-amoxiclav and metronidazole for 6 weeks.

2009 Emergency Medicine Journal

182. Lemierre syndrome complicating otitis externa: case report and literature review. (Abstract)

Lemierre syndrome complicating otitis externa: case report and literature review. Septic thrombophlebitis of the internal jugular vein, known as Lemierre syndrome, is a rare disorder usually caused by Fusobacterium necrophorum, a Gram-negative anaerobic organism that normally inhabits the oropharynx. Lemierre syndrome usually follows primary oropharyngeal infections and affects previously healthy adolescents and young adults in a characteristic manner, often with fatal results if left untreated (...) . There have been a significantly increasing number of reported cases of Lemierre syndrome, possibly reflecting the trend to withhold antibiotics for initially uncomplicated oropharyngeal infections.We hope to alert the reader to a potentially fatal disease process that has recently been increasingly identified, by reporting a unique manifestation of Lemierre syndrome, and by reviewing the current literature.A 19-year-old woman presented to our Emergency Department with a chief complaint of fever, ear pain

2009 Journal of Emergency Medicine

183. The changing pattern of Fusobacterium infections in humans: recent experience with Fusobacterium bacteraemia. Full Text available with Trip Pro

The changing pattern of Fusobacterium infections in humans: recent experience with Fusobacterium bacteraemia. A retrospective study was conducted of 26 adult cases of fusobacterium bacteraemia that occurred between 1998 and 2003 at Center Hospitalier Universitaire de Grenoble, France. Most patients presented with pre-existing adverse medical conditions, including evolving malignant diseases (eight patients), recent surgery (four patients), and chronic organ failure (six patients). Only one (...) patient presented with a classic Lemierre's syndrome. These results suggest an opportunistic pattern of modern fusobacterium infections.

2006 Clinical Microbiology and Infection

184. Fusobacteriosis presenting as community acquired pneumonia. (Abstract)

Fusobacteriosis presenting as community acquired pneumonia. Fusobacterium species are anaerobic Gram-negative bacilli, which colonise the mucus membranes of man and animals and can cause a number of clinical manifestations including Lemierre's disease (postanginal septicaemia), abdominal infection and deep-seated abscesses. The incidence of fusobacterium infections appears to be increasing, and we present three cases of fusobacteriosis who presented with features of community acquired pneumonia

2005 Journal of Infection

185. Prevotella bivia necrobacillosis following infectious mononucleosis. (Abstract)

Prevotella bivia necrobacillosis following infectious mononucleosis. A case of Lemierre's syndrome is reported. Although Fusobacterium species are commonly associated with this presentation, Prevotella bivia was the causative micro-organism identified in this case. The finding that disseminated anaerobic sepsis followed primary EBV infection led to the construction of a hypothetical model of infection.

2006 Journal of Infection

186. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. Full Text available with Trip Pro

Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. Fusobacterium necrophorum is recognized as the cause of a severe life-threatening illness characterized by bacteraemia with metastatic abscesses following an acute sore throat (Lemierre's disease). However, the importance of F. necrophorum as a cause of simple sore throat in the community is unknown. Using quantitative real-time PCR with primers targeting the rpoB

2004 Journal of Medical Microbiology

187. Closed traumatic head injury: dural sinus and internal jugular vein thrombosis. (Abstract)

causes (eg, Lemierre's syndrome). A case of thrombosis of the transverse sinus, sigmoid sinus and internal jugular vein associated with a closed head injury as the result of a motorcycle accident is presented. (...) Closed traumatic head injury: dural sinus and internal jugular vein thrombosis. Dural sinus thrombosis (DST) has an annual incidence of 3-4 per million and can result from many aetiologies. Presentation of the disease can vary considerably, as can the aetiology and delay of symptoms to clinical detection. Symptoms on presentation include headache, seizures, focal neural deficits and altered mental status. There are many aetiological risk factors associated with DST, which include

2008 Emergency Medicine Journal

188. Fusobacterium necrophorum Middle Ear Infections in Children and Related Complications: Report of 25 Cases and Literature Review. (Abstract)

Fusobacterium necrophorum Middle Ear Infections in Children and Related Complications: Report of 25 Cases and Literature Review. Fusobacterium necrophorum is associated with Lemierre syndrome (pharyngitis with septic thrombosis of the internal jugular veins) but it can also be involved in other head and neck infections, including sinusitis, parotitis, dental infections, and otitis media.This retrospective study analyzes a series of 25 pediatric cases of acute otitis media caused by F (...) . necrophorum and treated in our institution between 1995 and 2006.We observed 3 clinical presentations: (1) uncomplicated otitis media (44%; n = 11); (2) acute mastoiditis (40%; n = 10); and (3) otogenic variant of Lemierre syndrome (16%; n = 4) associating acute mastoiditis, suppurative thrombophlebitis of the lateral and/or cavernous sinuses, meningitis syndrome, and sometimes distant septic metastasis or extensive osteolysis of the temporal bone. Sixty percent of these cases were diagnosed during

2008 Pediatric Infectious Dsease Journal

189. Septic pulmonary embolism: presenting features and clinical course of 14 patients. Full Text available with Trip Pro

) and included five women. Presenting symptoms included fever (93%), dyspnea (36%), pleuritic chest pain (29%), cough (14%), and hemoptysis (7%). The median duration of symptoms before diagnosis was 18 days (range, 5 to 180 days). A potential source or underlying condition that predisposed to SPE was identified in all 14 patients and included Lemierre syndrome (4 patients), central venous catheter infection (3 patients), prosthetic cardiac valve (2 patients), and pacemaker infection (2 patients). Two (...) Septic pulmonary embolism: presenting features and clinical course of 14 patients. Septic pulmonary embolism (SPE) is an uncommon disorder with an insidious onset and is difficult to diagnose.To characterize the presenting features and clinical course of patients with SPE.Retrospective study.Tertiary care, referral medical center.Fourteen subjects with SPE diagnosed during a 6-year period between 1996 and 2002.None.The median age of these patients was 37.5 years (range, 14 to 81 years

2005 Chest

190. "My back is killing me". Full Text available with Trip Pro

"My back is killing me". This is a case of a rare cause of back pain that presented to several clinicians before the diagnosis became obvious and the correct management was initiated. Lemierre's syndrome was confirmed at post mortem examination. We conclude that thoracic back pain should not be assumed to have a simple mechanical cause and that efforts should be made to discover the underlying aetiology.

2005 Emergency Medicine Journal

191. Sore Throat

[ ] . Immediate prescription of antibiotics . This option should be offered to people who: Are systemically very unwell. Have signs of serious illness and/or complications such as peritonsillar abscess or cellulitis. Are immunosuppressed. Have valvular heart disease. Have a significant comorbidity (eg, heart, lung, renal, liver or neuromuscular disease, cystic fibrosis). A discussion with patients/parents/carers should take place as to which strategy is best for individual patients. This decision should (...) . Respiratory difficulty. Dehydration. Severe suppurative complications (local abscess or cellulitis, which may compromise the airway). Severe systemic illness. Suspected Kawasaki disease or epiglottitis. Assess urgently and/or seek specialist advice in those who are immunocompromised. Urgent FBC should be done and medication such as carbimazole or disease-modifying antirheumatic agents should be withheld pending FBC results and specialist advice. Consider routine referral for consideration of tonsillectomy

2008 Mentor

192. Rigors

a fit or convulsion. There is a wide range of conditions that can be associated with rigors, such as: Cardiac . . Lemierre's syndrome. . Pulmonary . . Genitourinary . . . . Obstetric Over half of women in labour experience shaking rigors. Epidurals and fever seem to be associated with the rigors. Rheumatological . . Infectious diseases . . . . (miliary). . Louse-borne relapsing fever (endemic in Ethiopia). GI . . . Medication reactions (usually intravenous) . Gentamicin. Vancomycin. Interleukin II (...) infections, biliary disease, and gastrointestinal (GI) infections. Recent surgical procedures. Any relevant past medical history such as rheumatic heart disease. Recent foreign travel [ ] . Medication and allergies. Examination This should be performed according to the history. Care should be taken in children where even an otitis media or upper respiratory infection may have triggered a rigor. It should be remembered that rigors can be an early symptom in septicaemia, particularly meningococcal

2008 Mentor

193. Tonsillitis (Acute and Chronic)

dehydration. Peritonsillar abscess or cellulitis, parapharyngeal abscess, retropharyngeal abscess, or Lemierre's syndrome (as there is a risk of airway compromise or rupture of the abscess). Signs of marked systemic illness or sepsis. A suspected rare cause such as Kawasaki disease, diphtheria, or yersinial pharyngitis. Use clinical judgement to determine whether hospital admission is necessary in vulnerable people (eg, infants, very old people, and those who are immunosuppressed or immunocompromised (...) Guidelines. You may find the article more useful, or one of our other . In this article In This Article Tonsillitis In this article Tonsillitis is inflammation due to infection of the tonsils. Pharyngitis is inflammation of the oropharynx but not the tonsils. The tonsils tend to atrophy in early adulthood. In laryngitis there are few visible signs of infection but with soreness lower down the throat often associated with a hoarse voice. Epidemiology It is a very common condition, most frequent

2008 Mentor

194. Lemierre's--the sinister sore throat. (Abstract)

Lemierre's--the sinister sore throat. Lemierre's syndrome is a rare and sometimes life threatening condition that requires prompt management. A case is reported of a previously healthy young male with Lemierre's syndrome. He developed internal jugular vein and cavernous sinus thrombosis, metastatic abscesses in the temporal lobe and lungs, temporal lobe venous infarction and severe thrombocytopaenia. Discussed are aspects of clinical presentation, diagnosis and management issues.

2007 Journal of Laryngology & Otology

195. Was Systemic Venous Thrombosis Really Due to the Administration of Recombinant Factor VIIa? Or Was It Possibly a Manifestation of Lemierre Syndrome? Full Text available with Trip Pro

Was Systemic Venous Thrombosis Really Due to the Administration of Recombinant Factor VIIa? Or Was It Possibly a Manifestation of Lemierre Syndrome? 18941643 2009 01 09 2018 11 13 0730-2347 35 3 2008 Texas Heart Institute journal Tex Heart Inst J Was systemic venous thrombosis really due to the administration of recombinant factor VIIa? or was it possibly a manifestation of Lemierre syndrome? 373-4; author reply 374-6 Saeed Giovanni G Ganster George G Friedel Norbert N eng Comment Letter United (...) States Tex Heart Inst J 8214622 0730-2347 0 Recombinant Proteins EC 3.4.21.21 Factor VIIa IM Tex Heart Inst J. 2007;34(4):485-8 18172537 Bacterial Infections diagnosis Diagnosis, Differential Factor VIIa administration & dosage adverse effects Humans Jugular Veins Postoperative Hemorrhage drug therapy Recombinant Proteins administration & dosage adverse effects Syndrome Thrombophlebitis diagnosis Venous Thrombosis diagnosis etiology 2008 10 23 9 0 2009 1 10 9 0 2008 10 23 9 0 ppublish 18941643

2008 Texas Heart Institute Journal

196. Bilateral intraocular involvement in Lemierre's syndrome Full Text available with Trip Pro

Bilateral intraocular involvement in Lemierre's syndrome 16424550 2006 02 23 2018 11 13 0007-1161 90 2 2006 Feb The British journal of ophthalmology Br J Ophthalmol Bilateral intraocular involvement in Lemierre's syndrome. 249-50 Olson J L JL Mandava N N eng Case Reports Letter England Br J Ophthalmol 0421041 0007-1161 IM Adolescent Female Fusobacterium Infections diagnosis Fusobacterium necrophorum isolation & purification Humans Pharyngeal Diseases diagnosis microbiology Syndrome Visual

2006 The British journal of ophthalmology

197. Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction. Case report. (Abstract)

Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction. Case report. 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

2007 Journal of Neurosurgery

198. Lemierre's syndrome: a potentially fatal complication that may require vascular surgical intervention. Full Text available with Trip Pro

Lemierre's syndrome: a potentially fatal complication that may require vascular surgical intervention. Septic phlebitis of the internal jugular vein, Lemierre's syndrome, is extremely rare. However, Lemierre's syndrome may cause septic pulmonary emboli or result in fatal systemic sepsis, or both, if a timely diagnosis and appropriate treatment are not provided. We present a case of Lemierre's syndrome that occurred in an otherwise healthy young man. In this case, progression to a moribund state

2005 Journal of Vascular Surgery

199. Diagnosis of Lemierre Syndrome by Bedside Emergency Department Ultrasound. (Abstract)

Diagnosis of Lemierre Syndrome by Bedside Emergency Department Ultrasound. Oropharyngeal infections such as pharyngitis and odontogenic abscess are routinely encountered in emergency and primary care medical practice. Lemierre syndrome is a rare but serious complication of such infections. This syndrome is characterized by penetration of the primary infection into the lateral pharyngeal space, suppurative thrombophlebitis of the internal jugular vein, and metastatic infections resulting from (...) septic emboli. A combination of clinical suspicion, microbiologic identification of the causative organism, and diagnostic imaging may be required to make the diagnosis. We present a case of Lemierre syndrome that was rapidly diagnosed in the Emergency Department with bedside ultrasound of the internal jugular vein. This case suggests that bedside ultrasound, performed before other radiologic imaging, may lead to earlier diagnosis and treatment of this syndrome, which historically has been associated

2008 Journal of Emergency Medicine

200. A Lemierre syndrome variant caused by Staphylococcus aureus. (Abstract)

A Lemierre syndrome variant caused by Staphylococcus aureus. Lemierre syndrome is a rare clinical entity, characterized by thrombosis of the internal jugular vein that develops after an oropharyngeal infection. We report the case of a 22-year-old woman hospitalized initially for cellulitis of the face. In view of the aggravation of the clinical state (septic shock and multiple organ failure), a computed tomography of the neck was performed and revealed a thrombosis of the right internal

2008 American Journal of Emergency Medicine

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