title: Lemierre syndrome secondary to community-acquired methicillin-resistant Staphylococcus aureus infection associated with cavernous sinus thromboses.
abstract: BACKGROUND
  Lemierre Syndrome (LS) is a highly aggressive rare disease process with a predilection for young, healthy adolescents. Often beginning with a primary cervicofacial infection, LS rapidly progresses to thrombophlebitis of the cerebral vasculature, metastatic infection, and septicemia. Untreated LS can be rapidly fatal. Thrombus within the cerebral vasculature can have devastating neurological effects. Advances in antibacterial therapy have resulted in a global decline in the incidence of LS, and clinicians may not consider LS early in the disease process. Although the mortality of LS has declined, the morbidity associated with the disease has increased, particularly the neurological sequelae.
  
  
  OBJECTIVE
  This report will provide readers with a better understanding of the etiology, clinical presentation, evaluation methods, and appropriate treatment of LS.
  
  
  METHODS
  We present an atypical case of LS secondary to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection progressing to bilateral cavernous sinus and ophthalmic vein thromboses with resultant binocular vision loss secondary to optic nerve and retinal ischemia.
  
  
  CONCLUSIONS
  This case highlights the importance of early recognition of LS in the setting of a community-acquired MRSA infection as the unifying condition in a young patient with multiple acute neurologic impairments.
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Stauffer
authors.forename: Anne F
authors.initials: AF
authors.lastname: Josiah
authors.forename: Manuel
authors.initials: M
authors.lastname: Fortes
authors.forename: Jay
authors.initials: J
authors.lastname: Menaker
authors.forename: John W
authors.initials: JW
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D001766:Blindness / Q000209:etiology; D020226:Cavernous Sinus Thrombosis / Q000150:complications / Q000209:etiology*; D017714:Community-Acquired Infections / Q000150:complications; D004636:Emergency Service, Hospital; D005123:Eye / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000209:etiology; D057831:Lemierre Syndrome / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D018917:Optic Neuropathy, Ischemic / Q000150:complications / Q000209:etiology; D012171:Retinal Vessels; D013203:Staphylococcal Infections / Q000150:complications*; D020246:Venous Thrombosis / Q000209:etiology