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Severe atypical Lemierre syndrome caused by methicillin-sensitive Staphylococcus aureus: Two pediatric case reports

R El Hajj1, A Stanzelova2, C de Marcellus3

  • 1Pediatrics, André Mignot Hospital, Versailles, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|March 29, 2023
PubMed
Abstract

Insights

Atypical Lemierre syndrome, often caused by Staphylococcus aureus, presents with unique symptoms like exophthalmia and lung infections. Prompt treatment with antibiotics and anticoagulation led to favorable outcomes in two pediatric cases.

Area of Science:

  • Infectious Diseases
  • Pediatric Medicine
  • Neurology

Background:

  • Lemierre syndrome classically results from Fusobacterium necrophorum ENT infections.
  • Atypical cases linked to Staphylococcus aureus have emerged since 2002.

Observation:

  • Two pediatric patients presented with exophthalmia, absent pharyngitis, lung metastases, and intracranial venous sinus thrombosis.
  • These symptoms mimicked Lemierre syndrome but were associated with Staphylococcus aureus.

Findings:

  • Both pediatric patients achieved favorable outcomes.
  • Treatment involved antibiotics, anticoagulation, and corticosteroids.
  • Therapeutic antibiotic level monitoring optimized antimicrobial therapy.

Implications:

  • Highlights the importance of considering Staphylococcus aureus in atypical Lemierre-like syndromes.
  • Emphasizes the critical role of multidisciplinary treatment including antibiotics, anticoagulation, and monitoring.
  • Suggests a need for increased awareness of this potentially severe condition in pediatric populations.
Keywords:
Lemierre syndromePediatric intensive careStaphylococcus aureusTherapeutic drug monitoring

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