Lemierre's syndrome.Lemierre's syndrome is characterized by thrombophlebitis of the internal jugular vein internal jugular vein n. and a spreading secondary infection. (1,2) When it occurs, it usually does so in young, previously healthy patients following an oropharyngeal infection accompanied by a persistently high fever. The overall incidence of this syndrome appears to be increasing. A vein that is a continuation of the sigmoid sinus of the dura mater and unites behind the cartilage of the first rib with the subclavian vein to form the brachiocephalic vein. The primary pathogen in Lemierre's syndrome is Fusobacterium 1. A rod-shaped bacterium in which the cell is thicker in the center and tapers toward the ends. 2. an organism of the genus Fusobacterium. Fu·so·bac·te·ri·um (fy  neerophorum, a gram-negative rod that normally inhabits the oropharynx. (1,2) Prolonged antibiotic treatment with good anaerobic coverage is vital to minimizing morbidity and mortality; the mortality rate associated with Lemierre's syndrome prior to the antibiotic era was nearly 90%. (3) Today, with early diagnosis and treatment, the mortality rate has decreased to 15%. (3) We evaluated a 21-year-old black man who presented with exudative tonsillitis and high fever. He had no significant medical history. Computed tomography (CT) of the neck detected a thrombosis of the right anterior jugular vein anterior jugular vein n. that extended from the level of the hyoid A vein that arises below the chin from the veins draining the chin and lower lip, passes down the front of the neck superficially, and terminates in the external jugular vein at the lateral border of the anterior scalene muscle. 1. Shaped like the letter U. 2. Of or relating to the hyoid bone. n. to the supraclavicular area (figure, A). CT of the chest revealed multiple cavitary The hyoid bone. 1. Relating to or having a cavity or cavities. 2. Of, relating to, or being an animal parasite that has a body cavity and lives within the host's body. In the presence of appropriate clinical features, the clinician should consider Lemierre's syndrome when cross-sectional imaging of the neck and chest demonstrates a thrombosed internal jugular vein and multiple septic emboli emboli /em·bo·li/ (em´bo-li) plural of embolus.. References (1.) Gormus N, Durgut K, Ozergin U, et al. Lemierre's syndrome associated with septic pulmonary embolism air embolism that due to air bubbles entering the veins from trauma, surgical procedures, or severe decompression sickness. cerebral embolism embolism of a cerebral artery. coronary embolism embolism of a coronary artery. : A case report. Ann Vasc Surg 2004; 18:243-5. (2.) Sagowski C, Koch U. [Lemierre syndrome: Thrombosis of the internal jugular vein after tonsillectomy]. HNO HNO - Hals Nasen Ohrenheilkunde HNO - Hals-Nasen-Ohren Heilkunde (German: throat, nose and ear medicine) HNO - Harvard News Office HNO - Helvetica Narrow Oblique (font) HNO - Host Network Operator HNO - Hungarian National Observatory 2004;52:251-4. (3.) Weesner CL, Cisek JE. Lemierre syndrome: The forgotten disease. Ann Emerg Med 1993;22:256-8. David Kirsch, MD; Devin Tighe, MD; Michael G. D'Antonio, MD; Enrique Palacios, MD, FACR FACR - Facilities Engineering & Design Requirements FACR - Fellow of the American College of Radiology FACR - Fellow of the American College of Rheumatology FACR - First Article Configuration Review From the Department of Radiology, Louisiana State University Health Sciences Center and VA Medical Center, New Orleans. |
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