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Lemierre Syndrome

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201. Lemierre's Syndrome: Methicillin-Resistant Staphylococcus aureus (MRSA) Finds a New Home. (Abstract)

Lemierre's Syndrome: Methicillin-Resistant Staphylococcus aureus (MRSA) Finds a New Home. Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein, arising as a complication of an oropharyngeal infection. This thrombophlebitis frequently results in septic emboli to organs such as the lungs. The causative agent in most previously described cases is Fusobacterium necrophorum, an anaerobic Gram-negative organism. We present the case of an 8-year-old previously healthy girl who (...) came to the Emergency Department with a 5-day history of left-sided neck pain and was subsequently diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) Lemierre's syndrome. MRSA has not previously been described in Lemierre's syndrome in the Emergency Medicine literature. The clinical presentation, findings, and management of the syndrome are discussed. Regardless of etiology, once the diagnosis of Lemierre's syndrome is made, long-term broad-spectrum intravenous therapy

2008 Journal of Emergency Medicine

202. Infection by Panton Valentine leukocidin-producing Staphylococcus aureus clinically mimicking Lemierre's syndrome. Full Text available with Trip Pro

as Lemierre's syndrome is reported here. A 32-year-old fit and otherwise healthy male presented on Christmas morning with a boil on his left cheek for 2 days and generalized rash for 3 h. His general condition began to worsen, he developed facial swelling and loss of vision in the left eye and was transferred to the intensive care unit. His treatment was taken over by team of specialists and further investigations revealed thrombophlebitis of the left internal jugular vein and cavernous sinus thrombosis (...) with multiple brain infarcts and lung abscesses. His condition remained critical with multiple cranial nerve involvement despite being on broad-spectrum antibiotics. Blood cultures grew S. aureus which was producing PVL toxin. He improved gradually over several weeks. He underwent intensive physiotherapy and made a good recovery. Although a rare entity, it is important to consider Lemierre's syndrome in septic patients who present with rapidly worsening symptoms.

2008 Journal of Medical Microbiology

203. Lemierre syndrome: two cases and a review. (Abstract)

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 (...) Lemierre syndrome: two cases and a review. 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

2007 Laryngoscope

204. A case of the otogenic variant of Lemierre's syndrome with atypical sequelae and a review of pediatric literature. (Abstract)

A case of the otogenic variant of Lemierre's syndrome with atypical sequelae and a review of pediatric literature. We report a case of an 8-year-old girl who presented with the clinical picture of Lemierre's syndrome (LS) secondary to bilateral mastoiditis. She developed unilateral sensorineural hearing loss (SNHL) along with internal jugular vein (IJV) thrombosis, septic arthritis of her ankle and cervical fasciitis. Combined antimicrobial, anticoagulant and surgical treatment helped reverse (...) all the effects of the sequelae, including nearly all the hearing loss. This is a unique case of this uncommon variant of the syndrome and with an uncommonly reported complication. The literature indicates that pediatric cases are a minority and enforces that successful management rests on awareness of the condition, vigil and promptness of communication of a multidisciplinary pediatric team.

2005 International Journal of Pediatric Otorhinolaryngology

205. Lemierre's syndrome: an unusual manifestation of spinal infection. (Abstract)

Lemierre's syndrome: an unusual manifestation of spinal infection. We report a case of Lemierre's syndrome complicated by an epidural abscess. This manifestation of Lemierre's syndrome has not been described previously.

2006 The Journal of Bone and Joint Surgery British Volume

206. Respiratory failure and hypercoagulability in a toddler with Lemierre's syndrome. Full Text available with Trip Pro

Respiratory failure and hypercoagulability in a toddler with Lemierre's syndrome. A 3.5-year-old healthy boy with 4 days of fever was referred to the emergency department for respiratory distress. The physical examination was remarkable for stupor, tachycardia, tachypnea, and dyspnea. Initial blood tests showed pancytopenia. He rapidly developed torticollis. Computerized tomography of the neck revealed a thrombus in the internal jugular vein. A presumptive diagnosis of Lemierre's syndrome (...) was made and he was started on antibiotics and anticoagulation. He subsequently developed adult respiratory distress syndrome and required high frequency oscillatory ventilation for 9 days. Blood cultures were positive for Fusobacterium necrophorum. Screening for hypercoagulability revealed 2 known risk factors: a mutation in the prothrombin gene and elevated lipoprotein a.

2005 Pediatrics

207. Lemierre's syndrome with fourth nerve palsy. (Abstract)

Lemierre's syndrome with fourth nerve palsy. Lemierre's syndrome is characterized by acute oropharyngeal infection with secondary internal jugular vein thrombophlebitis and subsequent metastatic infections. The anaerobe Fusobacterium necrophorum is the usual etiologic agent, although other microorganisms, including Streptococcus, Staphylococcus, Enterococcus, Bacteroides, and Lactobacilli, may be present alone or in combination with F. necrophorum. Common sites of metastatic infection include (...) the lungs and joints. Thromboembolic complications, such as septic pulmonary embolism, persistent jugular vein occlusion, hepatic abscesses, and nephropathy, may occur. We report a case of Lemierre's syndrome in a 3-year-old Caucasian boy who subsequently presented with manifestations of a fourth (trochlear) nerve palsy.

2008 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

208. Lemierre's syndrome: what are the roles for anticoagulation and long-term antibiotic therapy? (Abstract)

Lemierre's syndrome: what are the roles for anticoagulation and long-term antibiotic therapy? We wanted to describe what Lemierre's syndrome is and what risk factors may be involved, and to understand the roles, if any, of antibiotics and anticoagulants in the treatment of this syndrome.We performed a review of the pertinent literature regarding Lemierre's syndrome, as well as a review of otology, obstetrics and gynecology, and internal medicine literature looking at both anticoagulation (...) and long-term antibiotic treatment for septic thrombosis.The vast majority of patients with Lemierre's syndrome are successfully treated nonsurgically with antibiotics and, often, anticoagulation as well. Surgical intervention is reserved for those cases with persistent showering of septic emboli or continued propagation of the thrombosis. Although anticoagulation is commonly used in other specialties for similar septic thromboses, its role in Lemierre's syndrome is unclear at the present.Because

2008 Rhinology and Laryngology

209. Lemierre syndrome in a 5-month-old male infant: Case report and review of the pediatric literature. (Abstract)

media. He developed left-sided complicated otitis media with retroauricular fluid collection, mastoiditis, and temporomandibular joint effusion. The clinical picture was complicated by a left internal jugular vein and left lateral sinus thrombosis. Fusobacterium necrophorum grew in the pus culture.Low molecular weight heparin.No immunodeficiency and no thrombophilia were identified as predisposing conditions for Lemierre syndrome. Surgical drainage, early and adequate antibiotic treatment (...) Lemierre syndrome in a 5-month-old male infant: Case report and review of the pediatric literature. To report, to the best of our knowledge, the youngest patient with Lemierre syndrome.Descriptive case report with review of the pediatric literature.Pediatric intensive care unit in a tertiary referral hospital.Systemic review of the literature, including PubMed (English-only journals) and major textbooks.We report a 5-month-old boy who presented with fever and a perforated left-sided otitis

2008 Pediatric Critical Care Medicine

210. Fusobacterium necrophorum-induced sepsis: an unusual case of Lemierre's syndrome. (Abstract)

, and after a further 2 weeks was discharged home from hospital. This case highlights the need to raise the awareness of 'the forgotten disease': Lemierre's syndrome. Its diagnosis may, as in this case, be confounded by a lack of symptoms of pharyngitis at the time of presentation, and end-organ dysfunction associated with severe sepsis, possibly suggesting an alternative source of infection. As appropriate antibiotics reduce mortality dramatically, clinicians need to be alert to Lemierre's syndrome (...) Fusobacterium necrophorum-induced sepsis: an unusual case of Lemierre's syndrome. Classical Lemierre's syndrome is characterized by severe sepsis with metastatic abscess formation in young, previously fit people from a primary head or neck focus. The causative organisms are the anaerobic fusobacteria, most commonly Fusobacterium necrophorum. We describe the evaluation, therapeutic interventions and management of a patient with Lemierre's syndrome who presented in septic shock with multiple

2005 Acta Anaesthesiologica Scandinavica

211. Lemierre syndrome. (Abstract)

Lemierre syndrome. Lemierre syndrome is characterized by pharyngitis followed by Fusobacterium necrobacillosis sepsis complicated by internal jugular vein thrombosis and infectious metastatic abscesses. It has been considered to be a rare disease until the last decade when a larger number of cases have been reported. We discuss a case of Lemierre syndrome in a 17-year-old girl and review the pathophysiology of Fusobacterium necrobacillosis and diagnosis and treatment of Lemierre syndrome.

2005 Pediatric Emergency Care

212. Lemierre syndrome: a case report. (Abstract)

Lemierre syndrome: a case report. Lemierre syndrome is a condition that can have high morbidity and mortality, but if it is diagnosed early in a patient's workup, that is, in the ED, the morbidity and mortality can be significantly decreased. First described by Dr Andre Lemierre in 1936, Lemierre syndrome is a clinical condition, which presents as septic emboli in the internal jugular vein after an untreated pharyngitis. This condition can have significant morbidity and mortality; therefore (...) , although it is not common in today's era of antimicrobials, it should still be considered and thought of to prevent the significant consequences that may occur from it. In this article, we will present a child who was admitted for fever, neck pain, lymphadenopathy, and lung abscesses which was diagnosed as Lemierre syndrome. This syndrome will be discussed so as to heighten clinical awareness of it.

2007 Pediatric Emergency Care

213. Lemierre syndrome. (Abstract)

Lemierre syndrome. Lemierre syndrome is a disease that presents with oropharyngeal infection, sepsis, internal jugular vein thrombosis, and septic emboli with the Gram-negative organism Fusobacterium necrophorum cultured as the etiologic agent. Clindamycin, metronidazole and ampicillin-sulbactam are effective antibiotic treatments, although the length of treatment has not been firmly established. The syndrome is seen less frequently in the current age of antibiotics. It is important, however (...) , that physicians be aware of the syndrome as initiation of prompt antibiotic therapy, including anaerobic coverage, is essential for avoiding morbidity and mortality. We describe a case of Lemierre syndrome.

2005 Journal of Emergency Medicine

214. Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. (Abstract)

Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. 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.

2006 Journal of Laryngology & Otology

215. Lemierre's syndrome complicating bacterial pharyngitis in a patient with undiagnosed factor XII deficiency. (Abstract)

Lemierre's syndrome complicating bacterial pharyngitis in a patient with undiagnosed factor XII deficiency. Internal jugular vein thrombosis occurs as an uncommon complication of oropharyngitis. The following case report describes a previously healthy adult woman who presented with sore throat, left ear pain, and fever. She was initially diagnosed with pharyngitis and inadvertently had blood cultures sent as part of her workup. She was then called back to the Emergency Department the following

2007 Journal of Emergency Medicine

216. Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report. (Abstract)

Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report. Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.The unusual clinical (...) manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.The usual causative pathogen, namely Fusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial

2007 Journal of Laryngology & Otology

217. Lemierre syndrome: remember the forgotten disease. Full Text available with Trip Pro

Lemierre syndrome: remember the forgotten disease. 15651772 2005 03 07 2018 11 13 0041-6193 73 2 2004 Nov The Ulster medical journal Ulster Med J Lemierre syndrome: remember the forgotten disease. 123-5 McMullan R R Department of Infectious Disease, Royal Victoria Hospital, Belfast BT12 6BA. Ronan.McMullan@bll.n-i.nhs.uk McConville C C Clarke J C JC Adams D A DA Hedderwick S S eng Case Reports Journal Article Northern Ireland Ulster Med J 0417367 0041-6193 0 Anti-Bacterial Agents 0 (...) Anticoagulants IM Adolescent Anti-Bacterial Agents therapeutic use Anticoagulants therapeutic use Female Humans Jugular Veins Mastoiditis complications therapy Otitis Media complications drug therapy Otorhinolaryngologic Surgical Procedures methods Pulmonary Embolism etiology Sepsis etiology Syndrome Tomography, X-Ray Computed Treatment Outcome Venous Thrombosis complications drug therapy 2005 1 18 9 0 2005 3 8 9 0 2005 1 18 9 0 ppublish 15651772 PMC2475462 Clin Infect Dis. 2000 Aug;31(2):524-32 10987717 Ann

2004 The Ulster medical journal

218. Fusobacterium necrophorum as the cause of recurrent sore throat: comparison of isolates from persistent sore throat syndrome and Lemierre's disease. (Abstract)

Fusobacterium necrophorum as the cause of recurrent sore throat: comparison of isolates from persistent sore throat syndrome and Lemierre's disease. Fusobacterium necrophorum is a well established cause of Lemierre's disease (LD); a syndrome characterised by severe sore throat, septicaemia, multiple abscesses and jugular vein thrombosis. There is no published data concerning the role of F. necrophorum in recurrent sore throats. As the result of an index case of persistent sore throat (...) attributable to this organism being diagnosed in our laboratory, a subsequent case controlled study (not yet published) isolated F. necrophorum from 21% (P=0.0001) of cases of persistent, recurrent and chronic sore throats. The object of this study was to compare isolates of F. necrophorum from cases of systemic disease with isolates from cases of persistent sore throat syndrome (PSTS) to ascertain whether strains of similar type were responsible for both throat and systemic disease or whether different

2005 Journal of Infection

219. Critical care nurses be aware: Lemierre's syndrome is on the rise. (Abstract)

Critical care nurses be aware: Lemierre's syndrome is on the rise. Lemierre's syndrome (LS) typically occurs in previously healthy young adolescents and young adults who become acutely ill following an attack of pharyngotonsillitis. Also known as post anginal sepsis, those afflicted develop pyrexia, rigours and multiple metastatic abscesses that lead to septic thrombophlebitis of the internal jugular vein. In the pre-antibiotic era this particularly virulent syndrome had a mortality rate (...) and mortality. This paper discusses the aetiology, pathophysiology, bacteriology, diagnosis and management aspects of this syndrome. A case study of a young woman is presented to illustrate the complexity of the condition, and highlight how early diagnosis and prompt initiation of appropriate intravenous antibiotic therapy ensured a favourable clinical outcome.

2003 Australian Critical Care

220. Lemierre disease in the pediatric intensive care unit, clinical course, and the use of high-frequency oscillatory ventilation. (Abstract)

Lemierre disease in the pediatric intensive care unit, clinical course, and the use of high-frequency oscillatory ventilation. To highlight that cavitating pneumonias may be part of Lemierre disease, caused by Fusobacterium necrophorum. Also to report on the use of high-frequency oscillatory ventilation (HFOV) among other strategies, in the treatment of such a cavitating pneumonia.Case study.Tertiary pediatric intensive care unit in a university teaching hospital.A 45-kg, 14-yr old (...) occurrences during conventional ventilation. We would like to remind fellow clinicians that Lemierre disease may be the cause of cavitating pneumonias.

2003 Pediatric Critical Care Medicine

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