Lemierre's syndrome: what are the roles for anticoagulation and long-term antibiotic therapy?
OBJECTIVE
We wanted to describe what Lemierre's syndrome is and what risk factors may be involved, and to understand the roles, if any, of antibiotics and anticoagulants in the treatment of this syndrome.


METHODS
We performed a review of the pertinent literature regarding Lemierre's syndrome, as well as a review of otology, obstetrics and gynecology, and internal medicine literature looking at both anticoagulation and long-term antibiotic treatment for septic thrombosis.


RESULTS
The vast majority of patients with Lemierre's syndrome are successfully treated nonsurgically with antibiotics and, often, anticoagulation as well. Surgical intervention is reserved for those cases with persistent showering of septic emboli or continued propagation of the thrombosis. Although anticoagulation is commonly used in other specialties for similar septic thromboses, its role in Lemierre's syndrome is unclear at the present.


CONCLUSIONS
Because Lemierre's syndrome is so rare, it is difficult to ascertain absolutely the need for either anticoagulation or long-term antibiotic therapy. At this time, the risks and benefits of providing either therapy must be weighed against the potential complications of incompletely treating septic thrombosis.
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia 23708, USA.
Peter
P
Bondy
Thomas
T
Grant
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000925:Anticoagulants / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010608:Pharyngeal Diseases / Q000150:complications / Q000188:drug therapy*; D018805:Sepsis / Q000150:complications / Q000188:drug therapy*; D013577:Syndrome; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D000925:Anticoagulants