Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature

<b>Background:</b> Lemierre syndrome is a rare and life-threatening disease. It is characterized by septic thrombophlebitis of the internal jugular vein, historically associated with <i>Fusobacterium necrophorum</i> infection. However, atypical cases and associations with oth...

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Main Authors: Luca Pipitò, Antonio Anastasia, Fabrizio Passalacqua, Giulio D’Agati, Floriana Di Figlia, Benedetta Romanin, Silvia Bonura, Raffaella Rubino, Agostino Inzerillo, Caterina Sarno, Antonio Cascio
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Infectious Disease Reports
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Online Access:https://www.mdpi.com/2036-7449/16/6/86
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author Luca Pipitò
Antonio Anastasia
Fabrizio Passalacqua
Giulio D’Agati
Floriana Di Figlia
Benedetta Romanin
Silvia Bonura
Raffaella Rubino
Agostino Inzerillo
Caterina Sarno
Antonio Cascio
author_facet Luca Pipitò
Antonio Anastasia
Fabrizio Passalacqua
Giulio D’Agati
Floriana Di Figlia
Benedetta Romanin
Silvia Bonura
Raffaella Rubino
Agostino Inzerillo
Caterina Sarno
Antonio Cascio
author_sort Luca Pipitò
collection DOAJ
description <b>Background:</b> Lemierre syndrome is a rare and life-threatening disease. It is characterized by septic thrombophlebitis of the internal jugular vein, historically associated with <i>Fusobacterium necrophorum</i> infection. However, atypical cases and associations with other organisms have been reported. <b>Methods:</b> Here, we describe a challenging case of Lemierre syndrome in a 71-year-old woman caused by <i>Streptococcus constellatus</i> and review the related literature. <b>Case:</b> The patient experienced multiple hospital admissions due to misdiagnoses and developed thrombosis involving the internal jugular vein and transverse sinus bilaterally, pulmonary complications including the formation of a pseudoaneurysm, and occipital abscess. She presented with headaches, neck pain, and blindness. Prolonged antibiotic therapy was administered, leading to gradual improvement of symptoms, with partial resolution of blindness. Prophylaxis with intramuscular penicillin was prescribed at discharge. <b>Conclusions:</b> Our case underscores the importance of considering Lemierre syndrome in patients who present with multiple thrombotic events affecting the intracranial circulation and/or jugular veins, particularly in those already receiving anticoagulation therapy or with no identifiable cause for thrombosis, even in the absence of sore throat or fever.
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spelling doaj-art-a933b441e2774735a4b62da4e77a407a2025-08-20T02:53:33ZengMDPI AGInfectious Disease Reports2036-74492024-11-011661064107410.3390/idr16060086Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the LiteratureLuca Pipitò0Antonio Anastasia1Fabrizio Passalacqua2Giulio D’Agati3Floriana Di Figlia4Benedetta Romanin5Silvia Bonura6Raffaella Rubino7Agostino Inzerillo8Caterina Sarno9Antonio Cascio10Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90133 Palermo, ItalyInfectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyDepartment of Radiological Sciences, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90133 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90133 Palermo, ItalyInfectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyInfectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyInfectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyDepartment of Radiological Sciences, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyDepartment of Radiological Sciences, AOU Policlinico “P. Giaccone”, 90127 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90133 Palermo, Italy<b>Background:</b> Lemierre syndrome is a rare and life-threatening disease. It is characterized by septic thrombophlebitis of the internal jugular vein, historically associated with <i>Fusobacterium necrophorum</i> infection. However, atypical cases and associations with other organisms have been reported. <b>Methods:</b> Here, we describe a challenging case of Lemierre syndrome in a 71-year-old woman caused by <i>Streptococcus constellatus</i> and review the related literature. <b>Case:</b> The patient experienced multiple hospital admissions due to misdiagnoses and developed thrombosis involving the internal jugular vein and transverse sinus bilaterally, pulmonary complications including the formation of a pseudoaneurysm, and occipital abscess. She presented with headaches, neck pain, and blindness. Prolonged antibiotic therapy was administered, leading to gradual improvement of symptoms, with partial resolution of blindness. Prophylaxis with intramuscular penicillin was prescribed at discharge. <b>Conclusions:</b> Our case underscores the importance of considering Lemierre syndrome in patients who present with multiple thrombotic events affecting the intracranial circulation and/or jugular veins, particularly in those already receiving anticoagulation therapy or with no identifiable cause for thrombosis, even in the absence of sore throat or fever.https://www.mdpi.com/2036-7449/16/6/86<i>Streptococcus constellatus</i>Lemierre syndromethrombosesinternal jugular thrombosistransverse sinus thrombosis
spellingShingle Luca Pipitò
Antonio Anastasia
Fabrizio Passalacqua
Giulio D’Agati
Floriana Di Figlia
Benedetta Romanin
Silvia Bonura
Raffaella Rubino
Agostino Inzerillo
Caterina Sarno
Antonio Cascio
Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
Infectious Disease Reports
<i>Streptococcus constellatus</i>
Lemierre syndrome
thromboses
internal jugular thrombosis
transverse sinus thrombosis
title Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
title_full Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
title_fullStr Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
title_full_unstemmed Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
title_short Lemierre Syndrome Associated with <i>Streptococcus constellatus</i> and Atypical Vascular Involvement: A Case Report and Review of the Literature
title_sort lemierre syndrome associated with i streptococcus constellatus i and atypical vascular involvement a case report and review of the literature
topic <i>Streptococcus constellatus</i>
Lemierre syndrome
thromboses
internal jugular thrombosis
transverse sinus thrombosis
url https://www.mdpi.com/2036-7449/16/6/86
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