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Lemierre Syndrome: A Meta-analysis.

Mitchell R Gore1

  • 1Department of Otolaryngology, State University of New York Upstate Medical University, Syracuse, New York, United States.

International Archives of Otorhinolaryngology
|August 6, 2020
PubMed
Summary
This summary is machine-generated.

This meta-analysis found no statistically significant benefit of anticoagulation for Lemierre syndrome patients regarding vessel recanalization or mortality. Further research is needed to clarify the role of anticoagulation in this serious infection.

Keywords:
fusobacteriumsepsisthrombosis

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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.