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Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius

Lemierre's syndrome (LS) is a rare, but a life-threatening complication of an oropharyngeal infection. Combinations of fever, pharyngitis, dysphagia, odynophagia, or oropharyngeal swelling are common presenting symptoms. Infection of the lateral pharyngeal space may result in thrombosis of the...

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Autores principales: Gupta, Shalini, Merchant, Shehzad S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502875/
https://www.ncbi.nlm.nih.gov/pubmed/23197986
http://dx.doi.org/10.1155/2012/624065
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author Gupta, Shalini
Merchant, Shehzad S.
author_facet Gupta, Shalini
Merchant, Shehzad S.
author_sort Gupta, Shalini
collection PubMed
description Lemierre's syndrome (LS) is a rare, but a life-threatening complication of an oropharyngeal infection. Combinations of fever, pharyngitis, dysphagia, odynophagia, or oropharyngeal swelling are common presenting symptoms. Infection of the lateral pharyngeal space may result in thrombosis of the internal jugular vein, subsequent metastatic complications (e.g., lung abscesses, septic arthritis), and significant morbidity and mortality. LS is usually caused by the gram-negative anaerobic bacillus Fusobacterium necrophorum, hence also known as necrobacillosis. We present a case of LS caused by Streptococcus intermedius, likely secondary to gingival scraping, in which the presenting complaint was neck pain. The oropharyngeal examination was normal and an initial CT of the neck was done without contrast, which likely resulted in a diagnostic delay. This syndrome can be easily missed in early phases. However, given the potential severity of LS, early recognition and expedient appropriate antimicrobial treatment are critical. S. intermedius is an unusual cause of LS, with only 2 previous cases being reported in the literature. Therefore, an awareness of the myriad presentations of this syndrome, which in turn will lead to appropriate and timely diagnostic studies, will result in improved outcome for LS.
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spelling pubmed-35028752012-11-29 Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius Gupta, Shalini Merchant, Shehzad S. Case Rep Med Case Report Lemierre's syndrome (LS) is a rare, but a life-threatening complication of an oropharyngeal infection. Combinations of fever, pharyngitis, dysphagia, odynophagia, or oropharyngeal swelling are common presenting symptoms. Infection of the lateral pharyngeal space may result in thrombosis of the internal jugular vein, subsequent metastatic complications (e.g., lung abscesses, septic arthritis), and significant morbidity and mortality. LS is usually caused by the gram-negative anaerobic bacillus Fusobacterium necrophorum, hence also known as necrobacillosis. We present a case of LS caused by Streptococcus intermedius, likely secondary to gingival scraping, in which the presenting complaint was neck pain. The oropharyngeal examination was normal and an initial CT of the neck was done without contrast, which likely resulted in a diagnostic delay. This syndrome can be easily missed in early phases. However, given the potential severity of LS, early recognition and expedient appropriate antimicrobial treatment are critical. S. intermedius is an unusual cause of LS, with only 2 previous cases being reported in the literature. Therefore, an awareness of the myriad presentations of this syndrome, which in turn will lead to appropriate and timely diagnostic studies, will result in improved outcome for LS. Hindawi Publishing Corporation 2012 2012-11-04 /pmc/articles/PMC3502875/ /pubmed/23197986 http://dx.doi.org/10.1155/2012/624065 Text en Copyright © 2012 S. Gupta and S. S. Merchant. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Gupta, Shalini
Merchant, Shehzad S.
Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title_full Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title_fullStr Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title_full_unstemmed Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title_short Lemierre's Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
title_sort lemierre's syndrome: rare, but life threatening—a case report with streptococcus intermedius
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502875/
https://www.ncbi.nlm.nih.gov/pubmed/23197986
http://dx.doi.org/10.1155/2012/624065
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