[Lemierre syndrome: several clinical features of "a forgotten disease"]

Area of Science:

• Infectious Diseases
• Emergency Medicine
• Microbiology

Background:

• Lemierre syndrome (LS) is a rare but severe thrombotic complication of a head and neck infection, often associated with anaerobic bacteria.
• The incidence of LS has been suggested to be increasing due to changes in antibiotic prescribing patterns for oropharyngeal infections.
• This study reviews recent cases of LS managed in an emergency department setting.

Purpose of the Study:

• To review all cases of Lemierre syndrome diagnosed in an Emergency Department over a 5-year period.
• To analyze the clinical presentation, diagnostic findings, management, and outcomes of LS patients.
• To emphasize the importance of early diagnosis and appropriate treatment for Lemierre syndrome.

Main Methods:

• Retrospective study of patients diagnosed with LS in the Emergency Department.
• Data collected included patient demographics, clinical symptoms, laboratory results, radiological findings, treatment strategies, and patient outcomes.
• Descriptive analysis was performed on the collected data.

Main Results:

• Six patients with LS were identified, predominantly young males presenting with sore throat and pulmonary embolisms.
• Complications included severe sepsis, acute renal failure, hemoptysis, and hydropneumothorax.
• Antibiotic treatment, including carbapenems in three cases, was administered; anticoagulation was not consistently used without adverse events. No deaths were reported.

Conclusions:

• Lemierre syndrome remains a condition with significant morbidity, necessitating high clinical suspicion in young individuals with febrile pharyngeal symptoms.
• Early initiation of specific treatment, potentially including carbapenems, is vital to mitigate complications.
• The study highlights the importance of considering LS in the differential diagnosis of severe head and neck infections with systemic manifestations.