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Acute parotitis due to MRSA causing Lemierre's syndrome
Edward Alabraba1, Nichola Manu1, Gemma Fairclough1
1Liverpool NIHR Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool L69 3GA, UK.
Oxford Medical Case Reports
|June 27, 2018
Summary
Acute parotitis caused by MRSA can lead to Lemierre's syndrome, a rare but serious condition. Prompt diagnosis and treatment are crucial for favorable outcomes in these unique cases.
Area of Science:
- Infectious Diseases
- Surgical Complications
- Vascular Medicine
Background:
- Lemierre's syndrome, a rare thrombophlebitis of the internal jugular vein, typically arises from oropharyngeal infections.
- Acute parotitis is an uncommon antecedent infection associated with Lemierre's syndrome.
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in hospital-acquired infections.
Observation:
- A patient who underwent a pylorus-preserving pancreaticoduodenectomy developed right-sided acute parotitis.
- Septic thrombophlebitis of the right internal jugular vein was diagnosed in conjunction with the acute parotitis.
- The causative agent identified for both conditions was MRSA.
Findings:
- This case represents a unique instance of Lemierre's syndrome secondary to MRSA-induced acute parotitis.
- The literature review highlights the under-recognized association between acute parotitis and Lemierre's syndrome.
- MRSA as the causative agent in this specific parotitis-related Lemierre's syndrome context is novel.
Implications:
- Highlights the importance of considering acute parotitis in the differential diagnosis of internal jugular vein thrombophlebitis, especially post-operatively.
- Emphasizes the need for prompt diagnosis and aggressive antibiotic therapy for MRSA infections presenting as Lemierre's syndrome.
- Suggests that surgical patients may be at increased risk for unusual infectious complications like parotitis-related Lemierre's syndrome.