From a sore throat to the intensive care unit: the Lemierre syndrome.
Lemierre syndrome is characterized by an acute oropharyngeal infection, suppurative thrombophlebitis of the internal jugular vein and metastatic infections. The infection is usually caused by Fusobacterium necrophorum. We report on a 19-year-old male patient who was admitted with a five-day history of fever, sore throat and progressive dyspnea. Computed tomography of the neck and chest revealed a parapharyngeal abscess, jugular vein thrombosis, descending necrotizing mediastinitis and multiple areas of bilateral consolidation and cavitations within the lungs. Fusobacterium necrophorum was identified in the blood culture. Early combined abscess drainage with neck and chest incisions, together with broad spectrum intravenous antibiotic treatment and medical management in an intensive care unit resulted in a good clinical outcome.
Hochmair
Maximilian
M
Department of Respiratory and Critical Care Medicine, Otto-Wagner Hospital, Vienna, Austria.
Valipour
Arschang
A
Oschatz
Elisabeth
E
Hollaus
Peter
P
Huber
Monika
M
Chris Burghuber
Otto
O
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods; D005674:Fusobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D010612:Pharyngitis / Q000175:diagnosis* / Q000517:prevention & control*; D013577:Syndrome; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents