International Journal of Head and Neck Surgery

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VOLUME 14 , ISSUE 1 ( January-March, 2023 ) > List of Articles


Lemierre's Syndrome: A Retrospective Case Series

Shiv Kumar, Nishant Singh Gill, Resuciannie

Keywords : Hematogenous spread, Internal jugular vein, Internal jugular vein thrombosis, Neck infection, Neck swelling, Septicemia, Tenderness, Thrombophlebitis

Citation Information : Kumar S, Gill NS, Resuciannie. Lemierre's Syndrome: A Retrospective Case Series. Int J Head Neck Surg 2023; 14 (1):6-8.

DOI: 10.5005/jp-journals-10001-1543

License: CC BY-NC 4.0

Published Online: 21-02-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Lemierre's syndrome is a rare and less commonly occurring clinical condition that generally relates to the septic thrombophlebitis of the internal jugular vein. Common bacteria causing infection are Streptococci followed by Staphylococci and Klebsiella. The major proportion of cases that come to light are due to deep neck space infections that ultimately leads to thrombotic involvement of IJV, accounts for majority of the cases. The other causes include complications of chronic suppurative otitis media and thrombosis occurring in deep veins. Since the internal jugular vein is involved the infection can also undergo hematogenous spread. The infection generally spreads to spleen, liver, kidney, heart and brain. Lemierre's syndrome can be diagnosed on the basis of clinical symptoms, multitude of blood series and imaging. Since it is an infectious condition the treatment involves systemic antibiotic therapy and early administration of broad spectrum antibiotics in high dose become necessary for prevention of complications and systemic spread of infection. We are presenting a case series of 5 cases over a period of six years from November 2015 to November 2021. Materials and methods: This case series focused on the cases of Lemierre's syndrome that presented in the MBS Hospital, Kota over a course of 2 years from November 2019 to November 2021. The cases that were encountered were admitted, diagnosed and treated uneventfully. The investigations that the patients underwent were: blood cultures, chest skiagrams, contrast-enhanced computed tomography (CECT), skiagrams of mastoid bone, throat cultures and thorough clinical and ENT examination. Results: The observation and analysis of all the 5 recorded cases reveals that 2 cases of Lemierre's syndrome were having deep neck space infection as a causative factor in development of the disease and the other 2 cases were due to complications of chronic suppurative otitis media and the last remaining case had deep venous thrombosis as a causative factor for involvement of IJV and development of Lemierre's syndrome. Early administration of broad spectrum antibiotics is absolutely necessary on suspicion of Lemierre's syndrome so as to prevent adverse clinical outcome.

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