Lemierre Syndrome: A Meta-analysis

Area of Science:

• Infectious Diseases
• Vascular Surgery
• Critical Care Medicine

Background:

• Lemierre syndrome, a severe post-pharyngitis anaerobic sepsis, frequently involves internal jugular vein thrombosis.
• The efficacy of anticoagulation as an adjunct to antibiotics and surgery for Lemierre syndrome remains unclear.

Purpose of the Study:

• To conduct a meta-analysis of Lemierre syndrome outcomes and treatments.
• To evaluate the impact of anticoagulation on vessel recanalization and mortality in Lemierre syndrome.

Main Methods:

• A systematic PubMed search identified 427 studies on Lemierre syndrome.
• Data from 359 studies (394 patients, 1990-2017) were analyzed.
• Outcomes examined included vessel recanalization and mortality, specifically assessing the effect of anticoagulation.

Main Results:

• Anticoagulation showed an odds ratio of 1.6 for vessel recanalization (p=0.6) and 0.6 for mortality (p=0.5).
• Data were available for 50 patients on recanalization and 194 on mortality regarding anticoagulation use.
• No statistically significant effect of anticoagulation on vessel recanalization or mortality was demonstrated.

Conclusions:

• This meta-analysis did not find statistically significant evidence supporting anticoagulation for improved outcomes in Lemierre syndrome.
• The current literature does not support a significant role for anticoagulation in vessel recanalization or mortality reduction for Lemierre syndrome.