[Lemierre's syndrome: Diagnosis, exploration, treatment]

Rev Med Interne. 2018 May;39(5):339-345. doi: 10.1016/j.revmed.2017.11.005. Epub 2017 Dec 18.
[Article in French]

Abstract

Lemierre's syndrome is a rare and severe sepsis that can rapidly lead to a life-threatening condition in the absence of early management. This syndrome described at the beginning of the 20th century combines oropharyngeal infection complicated with septic thrombosis of the internal jugular vein and septic emboli predominantly pulmonary. Fusobacterium necrophorum, anaerobic germ, Gram negative bacillus is the main germ in this "necrobacillosis". The diagnosis is should be confirmed precociously with cervicothoracic CT-scan, reference exam, and bacteriological examinations (especially in atypical forms). Its management consists of an emergency antibiotic treatment, combining a third-generation cephalosporin or a betalactam with metronidazole, anticoagulant therapy to be reserved for high-risk situations related to thrombosis. Surgical treatment may be required.

Keywords: Abcès pulmonaires; Fusobacterium necrophorum; Infection oropharyngée; Jugular septic thrombosis; Lemierre's syndrome; Lung abscesses; Oropharyngeal infection; Syndrome de Lemierre; Thrombose septique jugulaire.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Anticoagulants / therapeutic use*
  • Female
  • Fusobacterium necrophorum / isolation & purification*
  • Humans
  • Lemierre Syndrome / diagnosis*
  • Lemierre Syndrome / therapy
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Anticoagulants