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lemierre syndrome anticoagulation

Laura Garcia, Kaori Ito
Case: Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is Fusobacterium necrophorum . A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea. She was admitted to the general practice unit with a diagnosis of acute pancreatitis then was subsequently transferred to the intensive care unit due to shock. Physical examination revealed tenderness on right side of the neck...
April 2018: Acute Medicine & Surgery
Thomas James Stubington, Paul James
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection...
January 3, 2018: BMJ Case Reports
Arnaud Martel
An 86-year-old patient was hospitalized for fever and left acute orbital syndrome (red eye with moderate visual impairment, chemosis, ophthalmoplegia without proptosis, or any fundus involvement). CT scan showed superior ophthalmic vein and cavernous sinus enlargement complicating ipsilateral sphenoidal sinusitis. Magnetic resonance imaging (MRI) demonstrated the left cavernous sinus thrombosis extended to the ipsilateral jugular vein and transversal sinus (Lemierre syndrome). Intravenous broad-spectrum antibiotics and curative anticoagulation were prescribed...
October 17, 2017: Orbit
Adam Alperstein, Raymond M Fertig, Matthew Feldman, Daniel Watford, Susan Nystrom, Guesly Delva, Salman Muddassir
An 18-year-old gentleman with a history of recurrent tonsillitis presented to the emergency room complaining of worsening sore throat. He was found to have a peritonisillar abscess, and imaging revealed a non-occlusive left internal jugular vein thrombosis. Lemierre's syndrome is a rare, potentially fatal condition characterized by internal jugular vein thrombosis with septicemia following an acute oropharyngeal infection. While anticoagulation is the mainstay of treatment of deep venous thromboembolism (DVT) and pulmonary embolism (PE), the use of therapy is controversial in septic thrombophlebitis...
May 2017: Intractable & Rare Diseases Research
Yun-Hu Wang, Po-Yen Chen, Pei-Ju Ting, Fang-Liang Huang
Cavernous sinus thrombosis (CST) is a severe disease which can result from infection of any of the tissues drained by the cavernous sinus. We here review eight cases, including a 12-year-old girl, all secondary to sphenoid sinusitis. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment and clinical outcomes were analyzed. All eight patients had headache and five of them fever. All cases were associated with one or more ophthalmic symptoms. In four cases, computed tomography/magnetic resonance imaging showed isolated sphenoid sinusitis...
September 2017: Infectious Diseases
Taisuke Kaiho, Takahiro Nakajima, Shuji Yonekura, Sawako Hamasaki, Takekazu Iwata, Ichiro Yoshino
Descending necrotizing mediastinitis is a severe infection of the mediastinum. Lemierre's syndrome manifests as thrombophlebitis in the cervical veins, which is caused by a neck infection. A 50-year-old woman had a fever with a 13-day history of neck pain. CT showed a deep neck abscess with vertebral vein thrombosis and mediastinal abscesses. Multiple small pulmonary nodules were found, suggesting septic pulmonary embolism. Emergency surgery for bilateral cervical and mediastinal drainage was performed, and antibiotics and anticoagulation agent was administered...
November 2017: General Thoracic and Cardiovascular Surgery
Margaret C Cupit-Link, Amulya Nageswara Rao, Deepti M Warad, Vilmarie Rodriguez
Lemierre syndrome (LS) is a multisystemic infection beginning in the oropharynx and leading to thrombosis of the internal jugular vein (IJV) with septic emboli and potential thrombotic extension to the central nervous system. Although patient outcomes have improved with early initiation of antimicrobial therapies, there is no consensus regarding the role of anticoagulation in LS. To better define the role of anticoagulation therapy in LS and determine whether anticoagulation improves thrombosis outcomes, we conducted a retrospective chart review of pediatric and adult patients diagnosed with LS and managed at our institution from January 1998 to December 2014...
2017: Acta Haematologica
Marianna Fabi, Francesca Lami, Maurizio Zompatori
A 12-year-old boy with a right atrium endocardial mass was initially diagnosed as having Lemierre's syndrome on the basis of previous mastoiditis and jugular vein and cerebral venous thrombosis. Lack of response to antibiotics, persistent high fever with chills, acute-phase reactants, and peripheral arterial pseudoaneurysms made us reconsider the diagnosis. Only after the late appearance of radiological pulmonary lesions and recognition of pulmonary artery aneurysms, Hughes-Stovin syndrome was diagnosed. Hughes-Stovin syndrome is an exceedingly rare vasculitis, especially in childhood, consisting of multiple pulmonary artery aneurysms and deep venous thromboses...
April 2017: Cardiology in the Young
Katrine M Johannesen, Uffe Bodtger
This is a systematic review of cases with Lemierre's syndrome (LS) in the past 5 years. LS is characterized by sepsis often evolving after a sore throat or tonsillitis and then complicated by various septic emboli and thrombosis of the internal jugular vein. Symptoms include sepsis, pain, and/or swelling in the throat or neck, as well as respiratory symptoms. Laboratory findings show elevated infectious parameters and radiological findings show thrombosis of the internal jugular vein and emboli in the lungs or other organs...
2016: Infection and Drug Resistance
Jenna Rebelo, Smriti Nayan, Karen Choong, Martha Fulford, Anthony Chan, Doron D Sommer
OBJECTIVE: To review the thrombotic complications of head and neck infections, including Lemierre's syndrome, and their management. METHODS: A retrospective review of pediatric patients presenting to McMaster Children's Hospital from 2009 to 2013 was undertaken. The literature was reviewed for evidence regarding the use of anticoagulation therapy in this population. RESULTS: Eleven cases (6 males, 5 females) were identified. The median age was 10...
September 2016: International Journal of Pediatric Otorhinolaryngology
Masayuki Kubota, Hiroaki Daidoji, Nobuhiro Takaya, Kurato Tokunaga, Tomohiro Sonoo, Kensuke Nakamura
No abstract text is available yet for this article.
October 2016: American Journal of Emergency Medicine
J Tschopp, C Chuard
Pharyngitis is a common cause of consultation in ambulatory medicine. Although it is benign in most cases, serious complications may happen and must be recognized quickly. Lemierre's syndrome is one of them. It consists in the association of thrombosis of the internal jugular vein and septic emboli that generally involve the lungs and is classically associated with Fusobacterium necrophorum. It is usually found in young and healthy adults and has an estimated mortality of 5%. Diagnosis relies essentially on the characteristic presentation of the disease...
October 7, 2015: Revue Médicale Suisse
Alan Chuncharunee, Thana Khawcharoenporn
Lemierre's syndrome is characterized by an oropharyngeal infection with internal jugular vein thrombosis followed by metastatic infections in other organs. This infection is usually caused by Fusobacterium spp. In this report, we present a rare case of Klebsiella pneumoniae-associated Lemierre's syndrome in a patient with poorly-controlled diabetes mellitus. The infection was complicated by septic emboli in many organs, which led to the patient's death, despite combined antibiotics, anticoagulant therapy, and surgical intervention...
August 2015: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Andreas V Hadjinicolaou, Yiannis Philippou
We report the case of a previously healthy, immunocompetent 23-year-old male who presented to the Emergency Department with general malaise, difficulty in breathing, fever, and chest pain. He reported a two-week history of progressively worsening sore throat that he presumed to be a viral infection and thus initially neglected. However, when his condition deteriorated, he was admitted to hospital acutely unwell and in respiratory distress. He quickly developed septic shock requiring intensive care admission for inotropic support...
2015: Case Reports in Medicine
Bo Mi Choi, Seong Wan Son, Chan Kwon Park, Sang-Hoon Lee, Hyung Kyu Yoon
Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma...
July 2015: Tuberculosis and Respiratory Diseases
Akihiro Nishida, Toshiyasu Ogata, Masataka Kudo, Kousuke Fukuhara, Jiro Fukae, Yoshio Tsuboi
The present report describes a 54-year-old woman with cavernous sinus thrombosis (CST) presenting with fever, and marked periorbital swelling. There is a history of untreated periodontal disease. On initial examination, periorbital pain associated with bilateral blephaloptosis, chemosis, and disturbed eye movement was present. The laboratory evaluation showed significant elevations in inflammatory and fibrinolytic markers. Diffusion-weighted MRI revealed high signal intensities in the bilateral superior ophthalmic veins (SOV)...
2015: Rinshō Shinkeigaku, Clinical Neurology
James A Coultas, Neena Bodasing, Paul Horrocks, Anthony Cadwgan
Lemierre's syndrome is a rare complication following an acute oropharyngeal infection. The aetiological agent is typically anaerobic bacteria of the genus Fusobacterium. The syndrome is characterised by a primary oropharyngeal infection followed by metastatic spread and suppurative thrombophlebitis of the internal jugular vein. If left untreated, Lemierre's syndrome carries a mortality rate of over 90%. Whilst relatively common in the preantibiotic era, the number of cases of Lemierre's syndrome subsequently declined with the introduction of antibiotics...
2015: Case Reports in Infectious Diseases
Michalis Agrafiotis, Evdokia Moulara, Diamantis Chloros, Venetia Tsara
No abstract text is available yet for this article.
May 2015: American Journal of Emergency Medicine
Midori Shimada, Yoshitomo Morinaga, Takeshi Kitazaki, Minoru Fukuda, Kohji Hashiguchi, Katsunori Yanagihara, Shigeru Kohno
A 76-year-old Japanese male presenting with high fever, headache, and disturbance of consciousness was hospitalized. Contrast computed tomography revealed thrombophlebitis in the internal jugular vein and abscesses in the posterior neck region, pharynx, and pterygoid muscle. Streptococcus constellatus infection was confirmed by culture of blood samples, and the patient was diagnosed with Lemierre syndrome. In addition to the administration of antibiotics and anticoagulants, abscess drainage was performed. S...
2014: Japanese Journal of Infectious Diseases
Adrian D Schubert, Michel-André Hotz, Marco D Caversaccio, Andreas Arnold
OBJECTIVES/HYPOTHESIS: Study of the clinical evolution of a primary ear, nose, and throat infection complicated by septic thrombophlebitis of the internal jugular vein. STUDY DESIGN: Retrospective case-control study. PATIENTS AND METHODS: From 1998 to 2010, 23 patients at our institution were diagnosed with a septic thrombosis of the internal jugular vein. Diagnostics included microbiologic analysis and imaging such as computed tomography, magnetic resonance imaging, and ultrasound...
April 2015: Laryngoscope
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