Arcanobacterium haemolyticum was isolated from the blood cultures of a previously healthy 37-year-old man who met all the criteria of Lemierre syndrome, including a primary oropharyngeal infection, evidence of thrombophlebitis of the internal jugular vein, and metastatic infections. To the best of our knowledge, this is the first case of Lemierre syndrome caused by A. haemolyticum in Korea and shows that A. haemolyticum alone can cause Lemierre syndrome.
Arcanobacterium ; Jugular Veins ; Korea ; Lemierre Syndrome ; Thrombophlebitis

Abscess ; microbiology ; Adolescent ; Humans ; Leg ; Lemierre Syndrome ; complications ; diagnosis ; Male

Lemierre’s syndrome (LS) is a rare life-threatening infective condition typically starting with an oropharyngeal infection causing thrombophlebitis and metastatic abscesses. The most common aetiology of LS is Fusobacterium necrophorum; however, it can also occur after infection with other organisms. LS mainly affects young healthy adults. The initial infection site can be in the head and neck or in the abdomen. The morbidity rate of this disease is high despite aggressive treatments. In this article, we report a 63-year-old male patient with uncontrolled diabetes mellitus, presenting with Klebsiella pneumoniae infection-induced necrotizing fasciitis on the right side of the neck, leading to LS.
Fasciitis, Necrotizing ; Lemierre Syndrome ; Fusobacterium necrophorum ; Klebsiella pneumoniae

Humans ; Lemierre Syndrome/drug therapy* ; Anti-Bacterial Agents/therapeutic use*

Lemierre's syndrome is characterized by a rare fulminant condition resulting from primary oropharyngeal infection followed by secondary septic thrombophlebitis of the internal jugular vein and metastatic infection. A forty-year-old man who had been on ventilator due to severe chest trauma, showed severe reddish inflammatory swelling of the right cervical soft tissue and newly developed pneumonia. He went into in septic condition shortly thereafter. Thrombophlebitis with central abscess in the right internal jugular vein was identified by neck CT and MRA(magnetic resonance angiography). Right cervical swelling worsened in spite of clindamycin and heparin therapy. We performed immediate surgery for removal of septic thrombus and resection of internal jugular vein. Patient's septic condition, pneumonia, and local inflammatory reaction were improved within several days after surgery.
Abscess ; Clindamycin ; Heparin ; Jugular Veins ; Lemierre Syndrome* ; Neck ; Pneumonia ; Thorax ; Thrombophlebitis ; Thrombosis ; Ventilators, Mechanical

Lemierre syndrome is characterized by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections such as septic pulmonary emboli and suppurative arthritis. In the preantibiotic era, this condition generally had a fatal outcome. The presentation is so distinctive that a clinical diagnosis is possible in most cases, and a cure is expected with the appropriate therapy in the majority of patients. We present a case report of Lemierre syndrome with a review of the relevant literature.
Arthritis, Infectious ; Diagnosis ; Fatal Outcome ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Thrombophlebitis

Lemierre syndrome is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. The usual etiologic agent is Fusobacterium necrophorum. Lemierre syndrome was a common disease with a high mortality rate in the pre-antibiotic era. Since the advent of antibiotics and their widespread use for the treatment of pharyngeal infections, there has been a substantial decrease in the incidence of this malady and it has become a "forgotten disease". Prompt diagnosis and antibiotic therapy for Lemierre syndrome is essential to avoid morbidity and mortality. We describe here a case of Lemierre syndrome with multiple septic pulmonary emboli.
Anti-Bacterial Agents ; Diagnosis ; Fusobacterium necrophorum ; Incidence ; Jugular Veins ; Lemierre Syndrome* ; Mortality ; Pharynx ; Pulmonary Embolism* ; Thrombophlebitis

Lemierre syndrome is a rare clinical condition that is characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein and frequent secondary metastatic infections. The accurate diagnosis and treatment, for early stage disease, is important because it may be associated with a high mortality rate if untreated. We present the case of a 34-year-old man who presented with a history of typical for the diagnosis of Lemierre syndrome. Supportive care with antibiotics did not improve the clinical condition. The clinical course improved after treatment with IV anticoagulant and surgical thrombectomy. In addition, he had the antiphospholipid syndrome, which is known to be a common cause of acquired arterial or venous thrombosis. Therefore, in this patient the associated antiphospholipid syndrome might precipitate an internal jugular venous thrombophlebitis after an oropharyngeal infection or might account for the poor response to medical treatment.
Adult ; Anti-Bacterial Agents ; Antiphospholipid Syndrome ; Empyema ; Humans ; Jugular Veins ; Lemierre Syndrome ; Pneumonia ; Thrombectomy ; Thrombophlebitis ; Venous Thrombosis

Lemierre syndrome is a rare disease involving multiple organs affected by septic emboli following oropharyngeal infection. After the introduction of penicillin in the 1940s, it became a "forgotten" disease. However, due to the development of diagnostic image modalities including neck computed tomography (CT) scan, the number of published reports of Lemierre syndrome and diagnosis has been increasing since the 1990s. In this report, we describe a case of Lemierre syndrome, following oropharyngeal infection in a 16-year-old patient, who manifested with persistent fever and neck stiffness. Neck ultrasonography confirmed thrombus formation in the right internal jugular vein without definite evidence of septic emboli to other organs. After the three-week-long antibiotics therapy was completed, the thrombus in the right internal jugular vein finally disappeared.
Adolescent ; Anti-Bacterial Agents ; Diagnosis ; Fever* ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Neck* ; Penicillins ; Rare Diseases ; Thrombophlebitis ; Thrombosis ; Ultrasonography

Abscesses are common in the oral and maxillofacial area. However, secondary thrombosis of the internal jugular vein accompanying the primary abscess is rare. In 1936, Andre Lemeierre studied 20 patients who showed an initial oropharyngeal infection, septicemia, internal jugular vein thrombosis, and secondary spread of the infection, and after then this condition Lemierre syndrome. Clinically, these patients present with tonsilitis lasting several days, continuous fever, and cervical pain. In the past, ligation and excision of the internal jugular vein was often performed. Current therapeutic modality for this condition is appropriate antibiotic prescription and surgical drainage of abscess. This case report presents a patient who showed symptoms of Lemierre syndrome, initiated as an oropharyngeal infection then developed thrombosis of the internal jugular vein. This patient was admitted into Seoul National University Dental Hospital. In addition to routine antibiotic therapy, surgical incision and drainage of the infection site was performed. Without ligation or excision, the thrombosed IJV disappeared eventually. As the Lemierre syndrome is not a common disease, this case report and review of the literature would be useful regarding a treatment of patients with Lemierre syndrome.
Abscess ; Drainage ; Fever ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Ligation ; Neck Pain ; Palatine Tonsil ; Prescriptions ; Seoul ; Sepsis ; Thrombosis