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Lemierre's syndrome mimicking leptospirosis
Dagmar Lin1, Nuntra Suwantarat, Royden S Young
1Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i 96813, USA. dagmarl@hawaii.edu
Hawaii Medical Journal
|August 4, 2010
Summary
Lemierre's syndrome, a rare condition involving internal jugular vein thrombophlebitis, can mimic severe leptospirosis. Early diagnosis of Fusobacterium necrophorum is vital to prevent life-threatening complications.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Critical Care Medicine
Background:
- Lemierre's syndrome is a rare but serious complication of oropharyngeal infections, characterized by internal jugular vein thrombophlebitis.
- It is most commonly caused by Fusobacterium necrophorum and often overlooked due to its infrequent occurrence.
Observation:
- A case is presented where Lemierre's syndrome initially mimicked severe leptospirosis (Weil's disease) presenting as acute febrile illness with multiorgan failure and hyperbilirubinemia.
- Computed tomography (CT) revealed bilateral pulmonary nodules and a right internal jugular vein thrombus.
Findings:
- Blood cultures confirmed the presence of Fusobacterium necrophorum as the causative agent.
- The clinical presentation highlighted the potential for Lemierre's syndrome to be misdiagnosed.
Implications:
- Early clinical suspicion of Lemierre's syndrome is critical for prompt diagnosis and treatment.
- Timely initiation of appropriate antibiotic therapy and diagnostic investigations can mitigate the risk of severe, life-threatening complications.
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