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Porphyromonas asaccharolytica as a Rare Causative Agent for Lemierre's Syndrome

Mridul Gupta1, Radhika Annam1, Joseph Bahgat2

  • 1Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA.

Case Reports in Infectious Diseases
|December 12, 2018
PubMed

Insights

Lemierre's syndrome, a rare but serious condition, can arise from throat infections. This case highlights a rare bacterial cause and emphasizes the need for prompt diagnosis and treatment of internal jugular vein thrombophlebitis.

Area of Science:

  • Infectious Diseases
  • Vascular Surgery

Background:

  • Lemierre's syndrome is a rare thrombophlebitis of the internal jugular vein, often originating from oropharyngeal infections.
  • It is associated with significant morbidity and mortality, particularly in young adults.
  • Fusobacterium necrophorum is the most common causative agent, while Porphyromonas asaccharolytica is a rare etiological agent.

Observation:

  • A previously healthy 22-year-old man presented with acute tonsillitis.
  • He developed left internal jugular vein thrombophlebitis with bilateral septic pulmonary emboli.
  • Porphyromonas asaccharolytica was identified as the causative organism.

Findings:

  • The patient was treated with ampicillin-sulbactam and metronidazole for five weeks.
  • Warfarin was administered for three months due to progression of the internal jugular vein thrombus.

Implications:

  • This case underscores the importance of considering rare pathogens in Lemierre's syndrome.
  • Prompt recognition and management of internal jugular vein thrombophlebitis are crucial for preventing metastatic complications.
  • Extended anticoagulation may be necessary in cases with thrombus progression.

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