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Complex Lemierre syndrome with multisystemic abscesses

We present here the challenging case of severe Lemierre syndrome in a healthy woman in her late twenties, whose clinical presentation was characterised by lung abscesses and disseminated systemic abscesses in the brain, the abdomen and the soft-tissues, as a likely consequence of a patent foramen ov...

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Autores principales: Bourgeaud, Johan, Delabays, Benoît, Van den Bogaart, Lorena, Ratano, Damian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10124225/
https://www.ncbi.nlm.nih.gov/pubmed/37085282
http://dx.doi.org/10.1136/bcr-2023-254638
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author Bourgeaud, Johan
Delabays, Benoît
Van den Bogaart, Lorena
Ratano, Damian
author_facet Bourgeaud, Johan
Delabays, Benoît
Van den Bogaart, Lorena
Ratano, Damian
author_sort Bourgeaud, Johan
collection PubMed
description We present here the challenging case of severe Lemierre syndrome in a healthy woman in her late twenties, whose clinical presentation was characterised by lung abscesses and disseminated systemic abscesses in the brain, the abdomen and the soft-tissues, as a likely consequence of a patent foramen ovale. Blood cultures were positive for Fusobacterium necrophorum and a right lingual vein thrombosis was detected at a late stage when the patient developed a septic shock. Initial antimicrobial therapy with metronidazole and ceftriaxone was modified to meropenem due to progressive worsening. The patient underwent laparoscopy and neurosurgical drainage of a cerebral abscess. She spent many days in the intensive care unit and recovered fully after 6 weeks on meropenem therapy. Although considered rare, the incidence of Lemierre syndrome, a potentially life-threatening condition, is increasing. The clinician should promptly recognise and treat it while being aware of its potential atypical presentations.
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spelling pubmed-101242252023-07-17 Complex Lemierre syndrome with multisystemic abscesses Bourgeaud, Johan Delabays, Benoît Van den Bogaart, Lorena Ratano, Damian BMJ Case Rep Case Reports: Rare disease We present here the challenging case of severe Lemierre syndrome in a healthy woman in her late twenties, whose clinical presentation was characterised by lung abscesses and disseminated systemic abscesses in the brain, the abdomen and the soft-tissues, as a likely consequence of a patent foramen ovale. Blood cultures were positive for Fusobacterium necrophorum and a right lingual vein thrombosis was detected at a late stage when the patient developed a septic shock. Initial antimicrobial therapy with metronidazole and ceftriaxone was modified to meropenem due to progressive worsening. The patient underwent laparoscopy and neurosurgical drainage of a cerebral abscess. She spent many days in the intensive care unit and recovered fully after 6 weeks on meropenem therapy. Although considered rare, the incidence of Lemierre syndrome, a potentially life-threatening condition, is increasing. The clinician should promptly recognise and treat it while being aware of its potential atypical presentations. BMJ Publishing Group 2023-04-21 /pmc/articles/PMC10124225/ /pubmed/37085282 http://dx.doi.org/10.1136/bcr-2023-254638 Text en © BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Rare disease
Bourgeaud, Johan
Delabays, Benoît
Van den Bogaart, Lorena
Ratano, Damian
Complex Lemierre syndrome with multisystemic abscesses
title Complex Lemierre syndrome with multisystemic abscesses
title_full Complex Lemierre syndrome with multisystemic abscesses
title_fullStr Complex Lemierre syndrome with multisystemic abscesses
title_full_unstemmed Complex Lemierre syndrome with multisystemic abscesses
title_short Complex Lemierre syndrome with multisystemic abscesses
title_sort complex lemierre syndrome with multisystemic abscesses
topic Case Reports: Rare disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10124225/
https://www.ncbi.nlm.nih.gov/pubmed/37085282
http://dx.doi.org/10.1136/bcr-2023-254638
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