Use of anticoagulation therapy for jugular vein thrombus in pediatric patients with Lemierre's syndrome.
BACKGROUND
Lemierre's syndrome is a rare condition involving septic thrombophlebitis of the internal jugular vein secondary to an acute oropharyngeal infection. The low incidence and prevalence of Lemierre's syndrome contribute to the many controversies pertaining to its therapeutic management, one of which is the use of anticoagulation for associated internal jugular vein thrombus.


METHODS
A previously healthy 5-year-old male admitted with left internal jugular vein thrombosis associated with Lemierre's syndrome was placed on appropriate antibiotics and anticoagulation therapy with enoxaparin. 3 weeks post-discharge, patient was found to be in good condition and a magnetic resonance angiography showed persistent occlusion of the left internal jugular vein.


CONCLUSIONS
Anticoagulation therapy for internal jugular vein thrombosis associated with Lemierre's syndrome remains a controversy. In the absence of any contraindication or presumed risk, anticoagulation therapy should be considered in high risk patients.
Department of Pharmacy, Moses H. Cone Memorial Hospital, 1200 N. Elm Street, Greensboro, NC 27401-1020, USA.
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D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007601:Jugular Veins; D057831:Lemierre Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D017984:Enoxaparin