Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction. Case report.
Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections. The authors present an unusual case of Lemierre syndrome in a 16-year-old boy with cavernous sinus thrombosis and right internal carotid artery narrowing without neurological sequelae, right subdural empyema, and cerebritis in the right temporal and occipital lobes. Neuroimaging also demonstrated right jugular vein thrombosis. Cultures of samples from the blood proved positive for the presence of Fusobacterium necrophorum. The patient underwent unilateral tonsillectomy, drainage of the peritonsillar abscess, and a myringotomy on the right side. Postoperatively the patient was treated conservatively with antibiotic therapy resulting in an excellent outcome.
Westhout
Franklin
F
Department of Neurosurgery, School of Medicine, University of California, Irvine, USA. westhout@yahoo.com
Hasso
Anton
A
Jalili
Mehrdad
M
Afghani
Behnoosh
B
Armstrong
William
W
Nwagwu
Chiedozie
C
Ackerman
Laurie L
LL
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000628:therapy; D020226:Cavernous Sinus Thrombosis / Q000175:diagnosis* / Q000628:therapy; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D013354:Empyema, Subdural / Q000175:diagnosis* / Q000628:therapy; D005674:Fusobacterium Infections / Q000175:diagnosis* / Q000628:therapy; D005675:Fusobacterium necrophorum; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000628:therapy; D000039:Peritonsillar Abscess / Q000175:diagnosis* / Q000628:therapy; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy
D000900:Anti-Bacterial Agents