Cargando…

Lemierre Syndrome: A Meta-analysis

Introduction  Lemierre syndrome, or postpharyngitis anaerobic sepsis, is an infrequent but life-threatening infection that often involves thrombosis of the internal jugular vein. The role of anticoagulation in addition to antibiotics and surgical treatment remains uncertain. Objectives  1) To perfor...

Descripción completa

Detalles Bibliográficos
Autor principal: Gore, Mitchell R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394644/
https://www.ncbi.nlm.nih.gov/pubmed/32754251
http://dx.doi.org/10.1055/s-0039-3402433
_version_ 1783565261725499392
author Gore, Mitchell R.
author_facet Gore, Mitchell R.
author_sort Gore, Mitchell R.
collection PubMed
description Introduction  Lemierre syndrome, or postpharyngitis anaerobic sepsis, is an infrequent but life-threatening infection that often involves thrombosis of the internal jugular vein. The role of anticoagulation in addition to antibiotics and surgical treatment remains uncertain. Objectives  1) To perform a meta-analysis on outcomes and treatment of Lemierre syndrome; and 2) to evaluate the effect of anticoagulation in Lemierre syndrome on vessel recanalization and on mortality. Data Synthesis  A Pubmed database search was conducted using the keywords Lemierre syndrome . A total of 427 studies were identified and reviewed. Data were extracted on patient demographics, treatment type including use and type of anticoagulation, type of antibiotics, presence and location of vessel thrombosis, presence of cranial neuropathies, recanalization of thrombosed vessels on follow-up imaging, organisms isolated on wound or blood cultures, and mortality. The primary outcome variables examined were the effect of anticoagulation on vessel recanalization and mortality. After the review, 359 studies totaling 394 patients between 1990 and 2017 had partial or complete data that could be analyzed. In total, 50 patients had sufficient data on the effect of anticoagulation on vessel recanalization, and 194 had sufficient data on the effect of anticoagulation on mortality. The odds ratio for anticoagulation and vessel recanalization was 1.6 (95% confidence interval = 0.3 to 9.4; p  = 0.6). The odds ratio for anticoagulation and death was 0.6 (95% confidence interval = 0.1 to 2.9; p  = 0.5). Conclusion  The present meta-analysis did not demonstrate a statistically significant effect on vessel recanalization or mortality for patients treated with anticoagulation versus patients not anticoagulated in the Lemierre syndrome literature.
format Online
Article
Text
id pubmed-7394644
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Thieme Revinter Publicações Ltda
record_format MEDLINE/PubMed
spelling pubmed-73946442020-08-03 Lemierre Syndrome: A Meta-analysis Gore, Mitchell R. Int Arch Otorhinolaryngol Introduction  Lemierre syndrome, or postpharyngitis anaerobic sepsis, is an infrequent but life-threatening infection that often involves thrombosis of the internal jugular vein. The role of anticoagulation in addition to antibiotics and surgical treatment remains uncertain. Objectives  1) To perform a meta-analysis on outcomes and treatment of Lemierre syndrome; and 2) to evaluate the effect of anticoagulation in Lemierre syndrome on vessel recanalization and on mortality. Data Synthesis  A Pubmed database search was conducted using the keywords Lemierre syndrome . A total of 427 studies were identified and reviewed. Data were extracted on patient demographics, treatment type including use and type of anticoagulation, type of antibiotics, presence and location of vessel thrombosis, presence of cranial neuropathies, recanalization of thrombosed vessels on follow-up imaging, organisms isolated on wound or blood cultures, and mortality. The primary outcome variables examined were the effect of anticoagulation on vessel recanalization and mortality. After the review, 359 studies totaling 394 patients between 1990 and 2017 had partial or complete data that could be analyzed. In total, 50 patients had sufficient data on the effect of anticoagulation on vessel recanalization, and 194 had sufficient data on the effect of anticoagulation on mortality. The odds ratio for anticoagulation and vessel recanalization was 1.6 (95% confidence interval = 0.3 to 9.4; p  = 0.6). The odds ratio for anticoagulation and death was 0.6 (95% confidence interval = 0.1 to 2.9; p  = 0.5). Conclusion  The present meta-analysis did not demonstrate a statistically significant effect on vessel recanalization or mortality for patients treated with anticoagulation versus patients not anticoagulated in the Lemierre syndrome literature. Thieme Revinter Publicações Ltda 2020-07 2020-04-24 /pmc/articles/PMC7394644/ /pubmed/32754251 http://dx.doi.org/10.1055/s-0039-3402433 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Gore, Mitchell R.
Lemierre Syndrome: A Meta-analysis
title Lemierre Syndrome: A Meta-analysis
title_full Lemierre Syndrome: A Meta-analysis
title_fullStr Lemierre Syndrome: A Meta-analysis
title_full_unstemmed Lemierre Syndrome: A Meta-analysis
title_short Lemierre Syndrome: A Meta-analysis
title_sort lemierre syndrome: a meta-analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394644/
https://www.ncbi.nlm.nih.gov/pubmed/32754251
http://dx.doi.org/10.1055/s-0039-3402433
work_keys_str_mv AT goremitchellr lemierresyndromeametaanalysis