Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T23:29:08.881Z Has data issue: false hasContentIssue false
  • English
  • Français

Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report

Published online by Cambridge University Press:  15 May 2007

S Georgopoulos ,
S Korres ,
M Riga ,
D Balatsouras ,
G Kotsis  and
E Ferekidis
S Georgopoulos
Affiliation:
ENT Department, Elpis General Hospital, Athens, Greece
S Korres
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
M Riga*
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
D Balatsouras
Affiliation:
ENT Department, Tzanion General Hospital, PiraeusGreece
G Kotsis
Affiliation:
Internal Medicine Department, Elpis General Hospital, Athens, Greece
E Ferekidis
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
*
Address for correspondence: Maria Riga, 7 Athenas str, 54634 Thessaloniki, Greece. Fax: 0030 210 8136971 E-mail: mariariga@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.

Case report:

The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.

Conclusion:

The usual causative pathogen, namely Fusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.

Keywords

Lemierre's SyndromeTonsillitisHaemolytic Uraemic Syndrome
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 527 - 530
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Hagelskjaer, LH, Prag, J, Malczynski, J, Kristensen, JH. Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990–1995. Eur J Clin Microbiol Infect Dis 1998;17:561–5CrossRefGoogle ScholarPubMed
2 Hagelskjaer, LH, Prag, J. Lemierre's syndrome: Diagnosis and management. Antimicrob Infectious Dis Newsletter 2000;18:17–20CrossRefGoogle Scholar
3 Sinave, C, Hardy, G, Fardy, P. The Lemierre syndrome: Suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine 1989;68:85–94CrossRefGoogle ScholarPubMed
4 Koay, CB, Heyworth, T, Burden, P. Lemierre syndrome. A forgotten complication of acute tonsillitis. J Laryngol Otol 1995;109:657–61CrossRefGoogle ScholarPubMed
5 Mc, Lean AS, Tyler, K. Cardiac tamponade in a postpartum woman with Lemierre's syndrome. Anaesth Intensive Care 1998;26:582–3Google Scholar
6 Goyal, M, Sharma, R, Jain, Y, Gupta, A, Berry, M. Unusual radiological manifestations of Lemierre's syndrome: a case report. Source Pediatr Radiol 1995;25:S105–6CrossRefGoogle ScholarPubMed
7 Eykyn, SJ. Necrobacillosis. Scand J Infect Dis Suppl 1989;62:41–6Google ScholarPubMed
8 Burden, P. Fusobacterium necrophorum and Lemierre's syndrome. J Infect 1991;23:227–31CrossRefGoogle ScholarPubMed
9 Leugers, CM, Clover, R. Lemierre syndrome: postanginal sepsis. J Am Boar Fam Pract 1995;8:384–91Google ScholarPubMed
10 Brazier, JS, Hall, V, Yusuf, E, Duerden, BI. Fusobacterium necrophorum infections in England and Wales 1990–2000. J Med Microbiol 2002;51:269–72CrossRefGoogle ScholarPubMed
11 Barker, J, Winer-Muram, HT, Grey, S. Lemierre syndrome. Southern Med J 1996;89:1021–3CrossRefGoogle ScholarPubMed
12 DeSena, S, Rosenfeld, DL, Santos, S, Keller, I. Jugular thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine 1989;68:85–94Google Scholar
13 Williams, A, Nagy, M, Wingate, J, Bailey, L, Wax, M. Lemierre syndrome: a complication of acute pharyngitis. Int J Pediatr Otorhinolaryngol 1998;45:51–7CrossRefGoogle ScholarPubMed
14 Elliott, EJ, Robins-Browne, RM. Hemolytic uremic syndrome. Curr Probl Pediatr Adolesc Health Care 2005;35:310–30CrossRefGoogle ScholarPubMed
15 Wieding, JU, Eisinger, G, Kostering, H. Diagnosis of disseminated intravascular coagulation: the value of soluble fibrin, D-dimers and fibrin(ogen) split products [in German]. Klin Wochenschr 1989;67:764–73CrossRefGoogle ScholarPubMed
16 Gilbert, DN, Moellering, RC, Sande, MA. Recommended antimicrobial agents against selected bacteria. In Gilbert, DN, Moellering, RC Jr., Sande, MA, eds. The Sanford Guide to Antimicrobial Therapy, Inc., 29th edn. Vienna, Va. 1999;48–50Google Scholar
17 Appelbaum, PC, Spangler, SK, Jacobs, MR. Susceptibilities of 394 Bacteroides fragilis, non-Bacteroides fragilis Bacteroides species and Fusobacterium species to newer antimicrobial agents. Antimicrob Agents Chemother 1991;35:1214–18CrossRefGoogle Scholar
18 Finegold, SM. Anaerobic Bacteria in Human Disease. New York: Academic Press, 1977;13–14Google Scholar