[Lemierre syndrome: several clinical features of "a forgotten disease"].
BACKGROUND
Lemierre syndrome (LS) is considered as a forgotten disease since the beginning of Penicillin. The lack of use of beta-lactamase inhibitors antibiotics together with the increase in the use of macrolids or second-generation and third-generation cephalosporins for oropharyngeal processes has led to an increasing incidence. We propose to review all LS cases seen in an Emergency Department over the last 5 years.


METHODS
Retrospective study of patients diagnosed as LS in the Emergency Department of Hospital general universitario Gregorio Marañón from 2004 to the present. Descriptive analysis of age, gender, clinical features, laboratory and radiological results, management and outcome.


RESULTS
We had 6 patients with LS. 5 males. Median age: 25 years old. All with sore throat and pulmonary embolisms. 2 patients with negative blood cultures. 1 patient was admitted into ICU because of severe sepsis. One of the 6 developed acute renal failure, another one hemoptysis, and another a hydropneumothorax which was drained. All the patients were managed with antibiotics against anaerobes, carbapenems in 3 cases. Two patients did not receive anticoagulants, with no complications recorded. There were no deaths.


CONCLUSIONS
LS still has a high morbidity, therefore it must be on mind in young people with febrile pharyngeal symptoms in order to start specific treatment as soon as possible to decrease complications. Carbapenems appears to be a good therapeutic choice.
Gargallo
Esther
E
Servicio de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, España. esthergargallo@yahoo.es
Nuevo
Jose Antonio
JA
Cano
Juan Carlos
JC
Castuera
Ana Isabel
AI
Andueza
Juan Antonio
JA
Fernández
María
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004630:Emergencies; D005260:Female; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007601:Jugular Veins / Q000000981:diagnostic imaging; D057831:Lemierre Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D000039:Peritonsillar Abscess / Q000150:complications* / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D018805:Sepsis / Q000209:etiology; D013030:Spain / Q000453:epidemiology; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D014463:Ultrasonography; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000925:Anticoagulants