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 inter...

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Main Authors: Shalini Gupta, Shehzad S. Merchant
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2012/624065
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author Shalini Gupta
Shehzad S. Merchant
author_facet Shalini Gupta
Shehzad S. Merchant
author_sort Shalini Gupta
collection DOAJ
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 doaj-art-8a7a3bd329374a61b578550424dafff82025-08-20T02:09:21ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/624065624065Lemierre’s Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermediusShalini Gupta0Shehzad S. Merchant1Department of Internal Medicine, Oregon Health Science University, P.O. Box BTE 119, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USAInfectious Diseases Division, Department of Medicine, Buffalo General Hospital, University at Buffalo, 100 High Street, B-8, Buffalo, NY 14203, USALemierre’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.http://dx.doi.org/10.1155/2012/624065
spellingShingle Shalini Gupta
Shehzad S. Merchant
Lemierre’s Syndrome: Rare, but Life Threatening—A Case Report with Streptococcus intermedius
Case Reports in Medicine
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
url http://dx.doi.org/10.1155/2012/624065
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