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[Diagnostic imaging in Lemierre's+ syndrome]
A Gato1, C García Aguado, O Mateo
1Servicio de Medicina Interna, Hospital Universitario de Getafe, Madrid.
Enfermedades Infecciosas Y Microbiologia Clinica
|May 1, 1993
Summary
Lemierre syndrome, a serious infection involving jugular thrombophlebitis and septic embolisms, can be diagnosed using advanced imaging. Early suspicion and diagnostic tools like echo-Doppler are crucial even without typical symptoms.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Vascular Surgery
Context:
- Lemierre syndrome, characterized by internal jugular vein thrombophlebitis and septic embolisms, is often caused by Fusobacterium necrophorum.
- Historically, diagnostic emphasis has been on clinical presentation, with limited reporting of imaging in previous literature.
- The syndrome presents a diagnostic challenge due to its potential for rapid deterioration and subtle initial signs.
Purpose:
- To highlight a case of Lemierre syndrome diagnosed via advanced imaging techniques.
- To emphasize the diagnostic utility of imaging, particularly echo-Doppler, in identifying internal jugular vein involvement.
- To review existing cases and underscore the importance of considering Lemierre syndrome in specific clinical contexts.
Summary:
- A case of Lemierre syndrome with Fusobacterium sepsis and pulmonary embolisms was diagnosed using echo-Doppler, revealing internal jugular vein involvement.
- Review of six cases indicated that imaging was underutilized, with diagnosis often relying solely on clinical and physical examination data.
- In only two of six reviewed cases were imaging techniques employed for internal jugular vein assessment.
Impact:
- Modern imaging, especially echo-Doppler, can significantly aid in the early diagnosis of Lemierre syndrome.
- Increased awareness and utilization of imaging can lead to prompt treatment and improved patient outcomes.
- This case underscores the need to suspect Lemierre syndrome in patients with Fusobacterium bacteremia and pulmonary embolism, irrespective of overt oropharyngeal or jugular symptoms.