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Lemierre's syndrome resulting from streptococcal induced otitis media and mastoiditis: a case report
Che M Harris1, Micean Johnikin, Hope Rhodes
1Howard University Hospital 2041 Georgia Avenue, NW, Washington, DC 20060 USA.
Introduction:
Lemierre's syndrome is an extremely rare and almost universally fatal disease characterized as thrombophlebitis of the internal jugular venous system with subsequent metastatic infection. Fusobacterium necrophorum is the most common organism implicated in causation of Lemierre's syndrome. Group A Streptococcus has mainly been observed as a polymicrobial organism in the syndrome. We report a rare finding of a rare disease where Group A Streptococcus was the sole organism triggering Lemierre's syndrome. To our knowledge, this is only the third recorded patient with such an occurrence.
Case Presentation:
We describe a 9-year-old African American boy, who presented with otitis media and mastoiditis that culminated in Lemierre's syndrome. Isolates bore only Group A Streptococcus. The patient was appropriately treated and responded with full recovery from the syndrome.
Conclusion:
Since Lemierre's syndrome is classically detected by clinical diagnosis, these findings should prompt clinicians to consider Group A Streptococcus as an alternative catalyst. It should be pondered that patients who present with typical Group A streptococcal infections have the possibility for developing Lemierre's syndrome. Though this complication appears to be rare, early diagnosis and prompt intervention have proven critical in survival outcome. Indeed, what would seem to be a routine case of strep throat or otitis media easily treated with antibiotics could end up being an unalterable progression to death unless Lemierre's syndrome is immediately diagnosed and treated.
Insights
Group A Streptococcus can solely cause Lemierre's syndrome, a rare and serious condition. Early diagnosis and treatment are crucial for survival, even with common infections like strep throat or otitis media.
Area of Science:
- Infectious Diseases
- Microbiology
- Pediatrics
Background:
- Lemierre's syndrome is a rare, often fatal condition involving internal jugular vein thrombophlebitis and metastatic infection.
- Fusobacterium necrophorum is the typical causative agent, with Group A Streptococcus usually a polymicrobial component.
- This case highlights a rare instance of Group A Streptococcus as the sole pathogen in Lemierre's syndrome.
Purpose of the Study:
- To report a rare case of Lemierre's syndrome caused exclusively by Group A Streptococcus.
- To emphasize the need to consider Group A Streptococcus as a potential sole causative agent in Lemierre's syndrome.
- To underscore the importance of early diagnosis and prompt intervention for Lemierre's syndrome.
Main Methods:
- Case report of a 9-year-old boy presenting with otitis media and mastoiditis.
- Identification of Group A Streptococcus as the only isolated organism.
- Clinical management and recovery of the patient.
Main Results:
- Group A Streptococcus was identified as the sole causative organism in a pediatric patient with Lemierre's syndrome.
- The patient received appropriate treatment and achieved a full recovery.
- This represents the third documented case of Lemierre's syndrome caused solely by Group A Streptococcus.
Conclusions:
- Clinicians should consider Group A Streptococcus as a potential sole cause of Lemierre's syndrome.
- Patients with typical Group A streptococcal infections may be at risk for developing Lemierre's syndrome.
- Prompt diagnosis and treatment are critical for improving survival outcomes in Lemierre's syndrome.
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