11/33. Serious consequences of a sore throat.Lemierre's syndrome, caused by fusobacterium necrophorum, is a potentially fatal sequelae of a sore throat characterised by septicaemia, internal jugular vein thrombophlebitis and metastatic abscesses. The Chief Medical Officer reported in February 2001 that the incidence is increasing. Two cases seen in one year, with different presentations, are reported. The first patient presented with sepsis, jaundice, hepatic abscesses and portal vein/superior mesenteric vein thrombosis, whilst the second presented with sepsis, sore throat and internal jugular vein thrombophlebitis. Both patients were treated with antibiotics and anticoagulants with a favourable outcome.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
12/33. lemierre syndrome variant: necrobacillosis associated with inferior vena cava thrombosis and pulmonary abscesses after trauma-induced leg abscess.fusobacterium necrophorum, a rarely encountered but potentially lethal bacterial pathogen, is the cause of lemierre syndrome, an oropharyngeal infection complicated by jugular vein thrombophlebitis and metastatic septic embolization. We describe an unusual variant of this disease in a man who developed F necrophorum sepsis (associated with extensive inferior vena cava and common femoral vein thrombosis) and multiple abscesses in the lungs after a trauma-associated abscess of the left lower extremity. We highlight the predilection of F necrophorum to cause a potentially fatal septic illness irrespective of its primary focus and emphasize the importance of this bacterium as a cause of considerable morbidity.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
13/33. Hyperbaric oxygen (HBO2) in the treatment of lemierre syndrome.In 1936 Lemierre described an aggressive neck infection with a high mortality rate. In the original characterization, he describes a pharyngotonsillitis and/or peritonsillar infection followed by unilateral swelling and tenderness along the sternocleidomastoid muscle owing to septic thrombophlebitis of the internal jugular vein. Subsequent to invasion and thrombophlebitis of the internal jugular vein, fusobacterium necrophorum septicemia occurs, with rigors, high fever, and septic thromboembolism to peripheral sites, especially the lungs and bones. This entity became known as lemierre syndrome. Hyperbaric oxygen (HBO2) has been described as adjunctive treatment in two cases of postanginal septicemia. This case describes the combined approach to a case of lemierre syndrome in which HBO2 was added as an adjunct to the treatment, with a favorable and rapid improvement in the patient's condition.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
14/33. 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 in excess of 90%, but since the introduction of antibiotics and the widespread treatment of throat infections, it has became almost unknown. However, due to a number of factors, including a reduction in the use of antibiotics for the treatment of sore throats, misdiagnosis and/or improvements in microbiology diagnostic techniques, several reports have indicated a resurgence of the condition. This has major ramifications for critical care nurses as LS is still associated with significant morbidity 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.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
15/33. Lemierre's syndrome: the forgotten disease. An unusual presentation of sepsis.A 19-year-old girl presented with a septical condition with fever of 40 degrees C, swelling of the right sternocleidomastoid region and abdominal pain. Except for a sore throat with pain strictly localized to the right side of her neck and fever over the last week there were no other clues in her past medical history. An abdominal ultrasound and MRT scan as well as a chest X-ray only showed non-specific findings. The diagnosis of Lemierre's syndrome was established by ultrasonographical detection of right jugular venous thrombosis and perivascular inflammation together with blood cultures positive for fusobacteria. The patient recovered within days after treatment was initiated with metronidazol according to the antibiogram. Lemierre's syndrome is a life-threatening disease especially in an age group which is less frequently affected by septicaemia. A history of sore throat, Fusobacterium positive blood cultures and ultrasonographical detection of jugular venous thrombophlebitis together with the knowledge of the "forgotten disease" will lead the way to the diagnosis.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
16/33. Complicated otitis media caused by fusobacterium necrophorum.fusobacterium necrophorum is implicated as an aetiological agent in a variety of necrotic diseases, such as Lemierre's syndrome (LS) in humans. LS was initially described as septic thrombophlebitis of the internal jugular vein secondary to an acute oropharyngeal infection. Other primary sources of infection include parotitis, otitis media, sinusitis, odontogenic infection and mastoiditis. In the pre-antibiotic era LS carried a high mortality. This has been reduced as a result of the widespread use of antibiotics, but there is still a definite morbidity and mortality associated with infection with this virulent organism. We report three cases of complicated otitis media caused by fusobacterium necrophorum. The patients were treated successively with intravenous metronidazole and surgery.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
17/33. Lemierre's syndrome: how a sore throat can end in disaster.Lemierre's syndrome is characterised by a history of recent oropharyngeal infection, clinical or radiological evidence of internal jugular vein thrombophlebitis and isolation of an anaerobic pathogen. We present a case report and review the literature.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
18/33. Lemierre's syndrome: three cases and a review.Postanginal sepsis, also called Lemierre's syndrome, is a rare but acute medical condition complicating oropharyngeal infection. The pathogenesis consists of the development of internal jugular vein septic thrombophlebitis leading to metastatic infections in the lung and other sites. The causative microorganism is most often fusobacterium necrophorum. We present three patients with Lemierre's syndrome who presented to the Leiden University Medical Center and give a review of the literature.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
19/33. Cerebral infarctions and brain abscess due to lemierre syndrome.lemierre syndrome is characterized by anaerobic bacterial infection in the head and neck, causing thrombophlebitis of the jugular vein and septic metastasis to various distant organs, most often the lungs. Here we describe previously unreported clinical features of cerebral infarctions and brain abscess due to metastatic septic embolism of this uncommon but lethal syndrome, and the successful course of treatment with ampicillin, cefotaxime and metronidazole.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
20/33. Lemierre's syndrome.Lemierre's syndrome is a rare, potentially severe disease consisting of septic emboli from an internal jugular vein thrombus after oropharyngeal infection. We report a 20-year-old man who had a tonsillitis with fever for 3 days. After a 2-day defervescence, fever relapsed as well as painful swelling over the left side of the neck. Computed tomography scan and sonography of the neck revealed thrombosis of left internal jugular vein and swelling of surrounding soft tissue. Chest radiograph demonstrated cavitary infiltrates over the left upper lobe. Septic thrombophlebitis of the internal jugular vein and metastatic pulmonary emboli was highly suspected. Intravenous ceftriaxone and metronidazole were given empirically. fusobacterium necrophorum was isolated from the blood culture with susceptibility to metronidazole. Complete defervescence and resolution of the neck swelling and pulmonary infiltrates occurred after antibiotic administration for 21 days. Lemierre's syndrome should be considered when encountering a febrile patient with painful neck swelling.- - - - - - - - - - ranking = 0.5keywords = thrombophlebitis (Clic here for more details about this article) |
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