A case of Lemierre syndrome

DOI
  • Tomioka Ryota
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Okazaki Noriko
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Katsube Yasuaki
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Takase Soitirou
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Shimada Rie
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Agata Ayumi
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University
  • Tsukahara Kiyoaki
    Department of otorhinolaryngology, head and neck surgery, Tokyo Medical University

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Other Title
  • 当院で経験したレミエール症候群の 1 例

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Description

<p>　[Introduction] Lemierre syndrome is characterized by four points as follow a preceding anaerobic infection of the pharynx; sepsis; a thrombus of internal jugular vein; and metastatic infection to the lungs and joints. Many cases are caused by the bacterium Fusobacterium necrophorum. The morbidity rate of Lemierre syndrome is 0.6-2.3 per one million, but its mortality rate is 4-22%. We report herein on a case of Lemierre syndrome. [Case] A 21-year-old man was aware of fever and right pharyngalgia. After several days, he had disturbance of consciousness and was brought to our hospital. His vital signs were indicative of shock when he was brought in and a marked inflammatory response was noted. CT imaging showed a thrombus of the internal jugular vein, inflammation of the skin and soft tissue of the right neck, right neck lymphadenitis and right pyothorax. Blood culture revealed F.necrophorum. His diagnosis was Lemierre syndrome. After admission, antibiotics and an anticoagulant were administered. He gradually recovered, and was discharged after 63 hospital days following admission, Antibiotics were discontinued 31days after discharge, followed by the anticoagulant at 38 days. He is currently disease-free. [Conclusion] Lemierre syndrome is a rare disease, but its mortality rate is very high. So, as any delay in the diagnose could have fatal consequences. We should be careful in our daily examination.</p>

Journal

  • Stomato-pharyngology

    Stomato-pharyngology 30 (2), 257-260, 2017

    Japan Society of Stomato-pharyngology

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