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Pediatric Lemierre's syndrome: A systematic review
Lama Aldawsari1, Jood Alzohari1, Raneem Khashab1
1Department of Surgery, Division of Otolaryngology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Summary
Lemierre syndrome (LS) in children is a serious condition involving internal jugular vein septic thrombophlebitis. Early diagnosis and prompt medical management are key to preventing complications and improving outcomes for pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Vascular Surgery
- Critical Care Medicine
Background:
- Lemierre syndrome (LS) is a rare but severe condition characterized by septic thrombophlebitis of the internal jugular vein.
- Prompt diagnosis and appropriate management are critical for favorable prognoses, yet its management in children remains debated.
- This study provides an updated overview of LS in pediatric patients, focusing on clinical presentation, management strategies, and outcomes.
Purpose of the Study:
- To update physicians on the clinical presentation, management, and prognosis of Lemierre syndrome in pediatric patients.
- To consolidate current evidence on the diagnosis and treatment of LS in individuals under 18 years old.
- To inform clinical practice and improve patient outcomes for pediatric LS cases.
Main Methods:
- A systematic review was conducted following PRISMA guidelines.
- Searches were performed on PubMed and Google Scholar using terms related to Lemierre syndrome, thrombophlebitis, internal jugular vein thrombosis, pediatrics, and F. necrophorum.
- Studies included pediatric patients (<18 years) diagnosed with LS.
Main Results:
- The review included 53 studies with 143 pediatric cases; mean age was 15.2 years.
- Fever (92%) was the most common symptom, and *F. necrophorum* was the predominant organism (78.3%).
- CT imaging (89.5%) effectively detected thrombosis and septic emboli. Antibiotics were universal; anticoagulation was used in 62.2%, surgery in 6%. Complications occurred in 4.2%, with a 1.4% mortality rate.
Conclusions:
- Early diagnosis and medical management of suspected Lemierre syndrome are crucial for preventing complications.
- Interdisciplinary collaboration is essential for optimizing patient care and improving outcomes in pediatric LS.
- Prompt recognition and treatment can significantly reduce morbidity and mortality associated with this condition.
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