Lemierre's syndrome: Difference between revisions
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==Background== | ==Background== | ||
*Also known as "Lemierre's disease" and "postanginal shock including sepsis" and "human necrobacillosis" | *Also known as "Lemierre's disease" and "postanginal shock including sepsis" and "human necrobacillosis" | ||
*Is a form of [[thrombophlebitis]]<ref> | *Is a form of [[thrombophlebitis]]<ref>"Lemierre syndrome" at Dorland's Medical Dictionary</ref> | ||
*Usually caused by ''[[Fusobacterium necrophorum]]'', and occasionally by other members of the genus ''Fusobacterium'' (''F. nucleatum, F. mortiferum and F. varium'' etc.) or [[MRSA]] | *Usually caused by ''[[Fusobacterium necrophorum]]'', and occasionally by other members of the genus ''Fusobacterium'' (''F. nucleatum, F. mortiferum and F. varium'' etc.) or [[MRSA]] | ||
*Usually affects young, healthy adults, most often developing after [[Strep Pharyngitis]] causing [[Peritonsilar Abscess]] | *Usually affects young, healthy adults, most often developing after [[Strep Pharyngitis]] causing [[Peritonsilar Abscess]] | ||
Revision as of 01:58, 19 March 2014
Background
- Also known as "Lemierre's disease" and "postanginal shock including sepsis" and "human necrobacillosis"
- Is a form of thrombophlebitis[1]
- Usually caused by Fusobacterium necrophorum, and occasionally by other members of the genus Fusobacterium (F. nucleatum, F. mortiferum and F. varium etc.) or MRSA
- Usually affects young, healthy adults, most often developing after Strep Pharyngitis causing Peritonsilar Abscess
- Anerobic bacteria grow in the PTA and penetrate into the neighboring jugular vein causing thrombophlebitis and bacteremia and septic emboli and occassionally pneumonia and sepsis[2]
Epidemiology
Very rare, incidence rate of 0.8 cases per million in the general population,[3]
Diagnosis
- Persistent sore throat, fever, and general weakness
- 2 days - 2 weeks after initial symptoms:
- lethargy, fevers, lymphadenopathy, painful neck
- Often abdominal pain, diarrhea, nausea and vomiting
- May lead to:
- Pneumonia
- Septic Arthritis
- Meningitis
- Sepsis
Differential Diagnosis
Workup
- CTA of neck
- Blood Cultures
Management
- Antibiotics
- IV Antibiotics
- Drainage of abscess
- Consider ligation of the internal jugular vein where antibiotic can not penetrate.[4][5][6]
- No evidence for or against anticoagulation[5]
Disposition
- Admit
- When diagnosed, mortality is 4.6%[7]
See Also
Sources
- ↑ "Lemierre syndrome" at Dorland's Medical Dictionary
- ↑ On certain septicemias due to anaerobic organisms. Lancet. 1936
- 1(5874)
- 701–3. doi:10.1016/S0140-6736(00)57035-4.
- ↑ [Lemierre syndrome: a diagnosis to keep in mind]. Revue médicale de la Suisse romande. 2004
- 124(11)
- 693–5. PMID 15631168.
- ↑ Cite error: Invalid
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<ref>tag; no text was provided for refs namedPuymirat - ↑ Lemierre syndrome in a 5-month-old male infant: Case report and review of the pediatric literature. Pediatric critical care medicine
- 9(5). doi
- 10.1097/PCC.0b013e31817319fa. PMID 18779698.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedSign In — Ann Intern Med