Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202301622
Jornal Vascular Brasileiro
Case Report

There is no well-being without oral health: a case report of Lemierre’s syndrome due to neglected odontogenic infection

Não há bem-estar sem saúde oral: relato de caso de síndrome de Lemierre por infecção odontogênica negligenciada

Edward Davis; Ardeno Kristianto; Andrew Jackson Yang

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Abstract

Lemierre’s syndrome is marked by presence of septic thrombophlebitis in the internal jugular vein. This case report describes a 57-year-old woman who presented with a progressively swelling neck with onset 1 day prior to admission. She had a history of untreated dental infection. Physical examination revealed slightly increased blood pressure, at 140/80 mmHg, and a painful, erythematous, warm swelling in the mid area of the neck. Ultrasound of the neck revealed occlusive intraluminal thrombus in the right internal jugular vein, a computed tomography (CT) scan with contrast showed that there was a blockage in the right jugular vein. The mainstay treatment for Lemierre’s syndrome is antibiotics, while administration of anticoagulants remains controversial. The patient was treated conservatively, with administration of antibiotics and anticoagulant. Several days later the patient’s condition had improved significantly, with less pain and reduced swelling.

Keywords

Lemierre’s syndrome; septic thrombophlebitis; dental infection; anticoagulant

Resumo

A síndrome de Lemierre é caracterizada pela presença de tromboflebite séptica da veia jugular interna. Este relato de caso descreve uma mulher de 57 anos que apresentou edema progressivo no pescoço 1 dia antes da internação. Ela tinha histórico de infecção dentária não tratada. O exame físico revelou pressão arterial levemente aumentada (140/80 mmHg), além de protuberância dolorosa, eritematosa e com aumento da temperatura na região média do pescoço. A ultrassonografia do pescoço revelou trombo intraluminal na veia jugular interna direita, e a tomografia computadorizada com contraste mostrou que havia trombose na veia jugular direita. O tratamento principal da síndrome de Lemierre é a antibioticoterapia, enquanto a administração de anticoagulantes permanece controversa. A paciente foi tratada de forma conservadora com administração de antibióticos e anticoagulantes. Vários dias depois, a condição da paciente melhorou significativamente, com diminuição do nível de dor e do tamanho da protuberância.

Palavras-chave

 síndrome de Lemierre; tromboflebite séptica; infecção dentária; anticoagulante

References

1 Camelo C, Brandao M, Fernandes L, et al. Lemierre syndrome: a case report. J Vasc Bras. 2015;14(3):253-7. http://doi.org/10.1590/1677-5449.0002.

2 Lemierre A. On certain septicaemias due to anaerobic organisms. Lancet. 1936;227(5874):701-3. http://doi.org/10.1016/S0140-6736(00)57035-4.

3 Creemers-Schild D, Gronthoud F, Spanjaard L, Visser LG, Brouwer CN, Kuijper EJ. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections? New Microbes New Infect. 2014;2(3):52-7. http://doi.org/10.1002/nmi2.39. PMid:25356344.

4 Salami A, Assouan C, Garba I, Konan E. An unusual cause of Lemierre Syndrome. J Stomatol Oral Maxillofac Surg. 2019;120(4):358-60. http://doi.org/10.1016/j.jormas.2019.02.009. PMid:30772450.

5 Syed MI, Baring D, Addidle M, Murray C, Adams C. Lemierre syndrome: two cases and a review. Laryngoscope. 2007;117(9):1605-10. http://doi.org/10.1097/MLG.0b013e318093ee0e. PMid:17762792.

6 Handa GI, Bertuzzo GS, Muller KS, et al. Síndrome de Lemierre: relato de caso. J Vasc Bras. 2010;9(1):82-5. http://doi.org/10.1590/S1677-54492010005000001.

7 Campo F, Fusconi M, Ciotti M, et al. Antibiotic and anticoagulation therapy in Lemierre’s syndrome: case report and review. J Chemother. 2019;31(1):42-8. http://doi.org/10.1080/1120009X.2018.1554992. PMid:30773133.

8 Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine. 2002;81(6):458-65. http://doi.org/10.1097/00005792-200211000-00006. PMid:12441902.

9 Aggarwal SK, Nath A, Singh R, Keshri A. Lemierre’s Syndrome presenting with neurological and pulmonary symptoms: case report and review of the literature. Ann Indian Acad Neurol. 2013;16(2):259-63. http://doi.org/10.4103/0972-2327.112489. PMid:23956578.

10 Bahall M, Giddings S, Bahall K. Lemierre’s syndrome: forgotten, but not absent. BMJ Case Rep. 2017;2017:bcr-2017-221203. http://doi.org/10.1136/bcr-2017-221203. PMid:28784905.

11 Veras RO, Barasuol LL, de Lira CP, et al. Lemierre syndrome: case report. J Vasc Bras. 2018;17(4):337-40. http://doi.org/10.1590/1677-5449.002418. PMid:30787954.

12 Alperstein A, Fertig RM, Feldman M, et al. Septic thrombophlebitis of the internal jugular vein, a case of Lemierre’s syndrome. Intractable Rare Dis Res. 2017;6(2):137-40. http://doi.org/10.5582/irdr.2017.01021. PMid:28580216.

13 Noh HJ, Freitas CA, Souza RP, Simões JC, Kosugi EM. Lemierre syndrome: a rare complication of pharyngotonsillitis. Rev Bras Otorrinolaringol. 2015;81(5):568-70. http://doi.org/10.1016/j.bjorl.2015.03.009. PMid:26324201.

14 Riordan T, Wilson M. Lemierre’s syndrome: more than a historical curiosa. Postgrad Med J. 2004;80(944):328-34. http://doi.org/10.1136/pgmj.2003.014274. PMid:15192164.
 


Submitted date:
12/17/2023

Accepted date:
03/25/2024

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