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[Lemierre's syndrome with splenic abscesses].
W Kern1, M Dolderer, D Krieger
1Sektion Infektionskrankheiten, Universität Ulm.
Deutsche Medizinische Wochenschrift (1946)
|October 2, 1992
Summary
Lemierre's syndrome, a rare post-tonsillitis complication, can lead to severe systemic infections. Prompt diagnosis and aggressive antibiotic therapy are crucial for managing this serious condition.
Area of Science:
- Infectious Diseases
- Bacteriology
- Internal Medicine
Background:
- Lemierre's syndrome is a rare but serious complication of oropharyngeal infections, often involving Fusobacterium necrophorum.
- Early recognition and prompt management are critical for favorable outcomes.
Observation:
- A previously healthy 23-year-old man presented with high fever, leukocytosis, thrombocytopenia, and elevated transaminases one week after pharyngo-tonsillitis.
- Chest imaging revealed intrapulmonary abscesses and pleural effusion, raising suspicion for Lemierre's syndrome.
- Blood cultures confirmed anaerobic, gram-negative bacteria, specifically Fusobacterium nucleatum and necrophorum.
Findings:
- Despite initial broad-spectrum antibiotics, the patient developed splenic abscesses, necessitating splenectomy.
- Post-splenectomy, abscess pus and splenic tissue cultures were sterile, indicating resolution of bacteremia.
- Prolonged antibiotic treatment, including chloramphenicol, was ultimately successful.
Implications:
- This case highlights the importance of considering Lemierre's syndrome in patients with severe systemic symptoms following pharyngo-tonsillitis.
- Aggressive and prolonged antibiotic therapy, tailored to the identified pathogens, is essential for treating this condition.
- Splenectomy may be required in complicated cases with abscess formation.