title: Isolated abducens nerve palsy secondary to Lemierre syndrome.
abstract: Lemierre syndrome is characterized by pharyngotonsillitis that is typically secondary to Fusobacterium necrophorum infection and causes adjacent septic thrombophlebitis and thrombosis with subsequent metastatic abscesses. A 3-year-old boy presented with fever, tonsillar enlargement, and bilateral otomastoiditis with purulent discharge. Physical examination revealed abducens nerve palsy on the left side, with a compensatory left head turn. Otomastoid discharge culture was positive for anaerobic F. necrophorum. Magnetic resonance venography of the head and neck revealed thromboses in left internal jugular vein, left cavernous sinus, left superior ophthalmic vein, and left sigmoid sinus. The patient was treated with anticoagulation and a 10-week course of intravenous antibiotics, including ceftriaxone and metronidazole.
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bababeygy
authors.forename: Hashem
authors.initials: H
authors.lastname: Almarzouki
authors.forename: Angela N
authors.initials: AN
authors.lastname: Buffenn
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002675:Child, Preschool; D005674:Fusobacterium Infections / Q000175:diagnosis*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification; D006801:Humans; D057831:Lemierre Syndrome / Q000150:complications* / Q000188:drug therapy; D008297:Male; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants