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Published on: July 29, 2022
[Case of Lemierre syndrome associated with infectious cavernous sinus thrombosis and septic meningitis]
Kouhei Shibuya1, Shuichi Igarashi, Tomoe Sato
1Department of Neurology, Niigata City General Hospital.
Abstract:
A 33-year-old man was admitted to our hospital because of right exophthalmos, diplopia and left neck pain. Neurological examination revealed lateral and inferior disturbance of his right eye movement and the meningeal irritation sign. Cerebrospinal fluid showed elevated polynuclear cells. Enhanced CT and MRI revealed thrombophlebitis of the left internal jugular vein and bilateral cavernous sinuses. On the basis of these findings, he was diagnosed as having Lemierre syndrome associated with cavernous sinus thrombophlebitis and bacterial meningitis. After administration of antibiotics, his symptoms disappeared and the data of laboratory analyses also improved. However, after his discharge, he was required re-antibiotics therapy because of septic embolus- induced multiple lung abscesses. Lemierre syndrome is characterized by disseminated abscesses and thrombophlebitis of the internal jugular vein after infection of the oropharynx. Because Lemierre syndrome is potentially life-threatening, early diagnosis and initiation of appropriate therapy are important.
Insights
Lemierre syndrome, a rare but serious condition, involves internal jugular vein thrombophlebitis and can lead to cavernous sinus thrombophlebitis and meningitis. Early antibiotic treatment is crucial for recovery and preventing complications like lung abscesses.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Lemierre syndrome is a rare but potentially fatal condition characterized by thrombophlebitis of the internal jugular vein, often following oropharyngeal infections.
- Cavernous sinus thrombophlebitis and bacterial meningitis are severe complications that can arise from Lemierre syndrome.
- Prompt diagnosis and management are critical due to the high morbidity and mortality associated with this syndrome.
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