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Lemierre's disease: a case with bilateral iliopsoas abscesses and a literature review

Nicholas Te Bird1, Derek Cocker2, Paul Cullis3

  • 1General Surgery, University Hospital Aintree, Lower Lane, Liverpool L97AL, UK.

World Journal of Emergency Surgery : WJES
|June 7, 2014
PubMed

Insights

Lemierre's disease, a serious infection, can manifest with unusual abscesses. This case report details a rare presentation involving bilateral iliopsoas abscesses, highlighting diagnostic challenges.

Area of Science:

  • Infectious Diseases
  • Internal Medicine
  • Clinical Microbiology

Background:

  • Lemierre's disease is a rare but severe condition typically originating from the oropharynx, characterized by internal jugular vein thrombosis and septic emboli.
  • Septic emboli can disseminate to various organs, including the lungs, brain, joints, and bones.
  • The diagnostic criteria for Lemierre's disease remain somewhat ambiguous, complicating early recognition.

Purpose of the Study:

  • To report an unusual case of Lemierre's disease presenting with bilateral iliopsoas abscesses.
  • To discuss the diagnostic challenges associated with Lemierre's disease.
  • To suggest refinements for the diagnostic criteria of Lemierre's disease.

Main Methods:

  • Case report of a 64-year-old male patient.
  • Clinical literature review on Lemierre's disease.
  • Analysis of diagnostic criteria and clinical presentations.

Main Results:

  • The patient presented with profound sepsis, acute kidney injury, bilateral iliopsoas abscesses, and a right hand abscess.
  • This represents the first reported case of Lemierre's disease associated with bilateral psoas abscesses.
  • The literature review confirmed difficulties in definitively diagnosing Lemierre's disease.

Conclusions:

  • Lemierre's disease can present with atypical manifestations, such as bilateral iliopsoas abscesses.
  • Refining diagnostic criteria is crucial for timely and accurate diagnosis of Lemierre's disease.
  • Early recognition and management are vital for improving patient outcomes in Lemierre's disease.
Keywords:
BilateralFusobacteriumFusobacterium NecrophorumIliopsoas abscessLemierre

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