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Lemierre's Syndrome: A Case Series.

Tariq M Jaber1, Vikram Saini1, Osakpolor Ogbebor2

  • 1Infectious Disease & Critical Care, Allegheny Health Network, Pittsburgh, USA.

Cureus
|November 5, 2021
PubMed
Summary

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Lemierre's syndrome (LS), a serious complication of throat infections, is resurging. A negative rapid strep test may delay diagnosis, highlighting the need for high clinical suspicion in persistent cases.

Area of Science:

  • Infectious Diseases
  • Vascular Surgery
  • Otolaryngology

Background:

  • Lemierre's syndrome (LS) is a severe complication of oropharyngeal infections, characterized by internal jugular vein (IJV) thrombosis and septic emboli.
  • Historically, LS was considered rare, but recent trends indicate a concerning resurgence.
  • Fusobacterium necrophorum is the most common pathogen, but others can be involved.

Observation:

  • The resurgence of LS may be linked to increased reliance on negative rapid antigen detection tests (RADTs) for Group A Streptococcus.
  • Clinicians may overlook LS in patients with persistent tonsillopharyngitis symptoms if initial strep tests are negative.

Findings:

  • A negative RADT for Group A Streptococcus should not rule out LS in patients with persistent oropharyngeal infection sequelae.
Keywords:
bacteremiafusobacterium necrophorumlemierre’s syndromeoropharyngeal infectionsepsis

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  • Prompt recognition and appropriate management are crucial for improving outcomes in LS patients.

    • Implications:

    • Healthcare providers must maintain a high index of suspicion for LS, even with negative rapid strep tests.
    • Revisiting diagnostic approaches for oropharyngeal infections is necessary to address the LS resurgence.
    • Public health strategies may need to address the changing epidemiology of LS.