Extensive Bilateral Lemierre Syndrome due to Methicillin-Resistant Staphylococcus epidermidis in a Patient with Lung Adenocarcinoma.
10.4046/trd.2015.78.3.289
- Author:
Bo Mi CHOI
1
;
Seong Wan SON
;
Chan Kwon PARK
;
Sang Hoon LEE
;
Hyung Kyu YOON
Author Information
1. Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
- Publication Type:Case Report
- Keywords:
Lemierre Syndrome;
Lung Adenocarcinoma;
Methicillin Resistance;
Staphylococcus epidermidis
- MeSH:
Adenocarcinoma*;
Anti-Bacterial Agents;
Ceftriaxone;
Female;
Humans;
Incidence;
Jugular Veins;
Lemierre Syndrome*;
Lung*;
Methicillin Resistance*;
Middle Aged;
Pulmonary Embolism;
Retropharyngeal Abscess;
Staphylococcus epidermidis*;
Stents;
Thrombophlebitis;
Vena Cava, Superior
- From:Tuberculosis and Respiratory Diseases
2015;78(3):289-292
- CountryRepublic of Korea
- Language:English
-
Abstract:
Lemierre syndrome (LS) is a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection. LS is commonly caused by normal anaerobic flora and treated with appropriate antibiotics and anticoagulation therapy. Although the incidence of disease is very rare, 15% cases of LS are fatal even in the antibiotic era because of disseminated septic thromboemboli. We reported a case of extensive bilateral LS due to methicillin-resistant Staphylococcus epidermidis in a 63-year-old female with lung adenocarcinoma. Initial examination revealed a retropharyngeal abscess; hence, intravenous ceftriaxone and steroid were initiated empirically. However, pulmonary thromboembolism developed and methicillin-resistant S. epidermidis was identified in the bacterial culture. Despite intensive antibiotic and anticoagulation therapies, extensive septic thrombophlebitis involving the bilateral IJV and superior vena cava developed. Adjunctive catheter-directed thrombolysis and superior vena cava stenting were performed and the patient received antibiotic therapy for an additional 4 weeks, resulting in complete recovery.
