title: Gastrointestinal Variant of Lemierre Syndrome: Fusobacterium nucleatum Bacteremia-Associated Hepatic Vein Thrombosis: a Case Report and Literature Review.
abstract: Fusobacterium nucleatum is a gram-negative bacillius commonly found in oropharynx and is traditionally associated with Lemierre syndrome, which is characterized by history of recent oropharyngeal infection, internal jugular vein thrombosis, and isolation of anaerobic pathogens, mainly Fuosobacterium necrophorum. However, recent evidence indicated that F. nucleatum is also a normal resident of human gut. Less than a dozen of case reports had linked F. nucleatum to gastrointestinal variant of Lemierre syndrome with portal vein thrombosis. However, F. nucleatum bacteremia-associated hepatic vein thrombosis is very rare. We report a case of a 73-year-old man who had hepatic vein thrombosis associated with F. nucleatum bacteremia, most likely from subclinical primary infection affecting the lower gastrointestinal tract. The underlying pathophysiology and treatment options are discussed here. With rapid increase in reporting of Lemierre syndrome, this case deserves particular attention from clinicians.
authors.affiliation: 1Division of Hospital Medicine, Department of Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ; and 2Pulmonary and Critical Medicine Fellowship Program, Department of Medicine, Texas A&M HSCCOM - Scott & White Healthcare, Temple, TX.
authors.forename: Lin
authors.initials: L
authors.lastname: Zheng
authors.forename: Badri
authors.initials: B
authors.lastname: Giri
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000382:microbiology*; D006502:Budd-Chiari Syndrome / Q000209:etiology* / Q000382:microbiology; D005674:Fusobacterium Infections / Q000150:complications* / Q000188:drug therapy; D016967:Fusobacterium nucleatum; D006801:Humans; D008297:Male
chemical_list: D000900:Anti-Bacterial Agents