Necrobacillosis resulting in isolated carotid thrombosis and massive stroke: a unique Lemierre variant?
We describe a healthy, young adult male patient who developed isolated carotid artery thrombosis and occlusion following acute pharyngitis due to Fusobacterium necrophorum. We believe this is the first case of isolated occlusion of internal carotid artery (ICA) with F.necrophorum without associated internal jugular vein (IJV) thrombosis. Lemierre's syndrome (LS) is characterized by a history of recent oropharyngeal infection in previously healthy individuals, clinical or radiological evidence of internal jugular vein thrombosis, and isolation of anaerobic pathogens, mainly F.necrophorum. We discuss literature on this rare, previously unreported, variant of LS.
Goyal
Munish Kumar
MK
Department of Neurology, University of Missouri Healthcare-Columbia, Columbia, Missouri, USA. goyalm@health.missouri.edu
Kumar
Gyanendra
G
Burger
Robert
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002341:Carotid Artery Thrombosis / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D018450:Disease Progression; D017809:Fatal Outcome; D005674:Fusobacterium Infections / Q000150:complications* / Q000188:drug therapy; D005675:Fusobacterium necrophorum; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010291:Paresis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D010612:Pharyngitis / Q000150:complications* / Q000382:microbiology* / Q000503:physiopathology; D010614:Pharynx / Q000098:blood supply / Q000382:microbiology; D012128:Respiratory Distress Syndrome / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D020521:Stroke / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D055815:Young Adult
D000900:Anti-Bacterial Agents