CASE REPORT

Central Nervous System Involvements of the Lemierre Syndrome: case report and mini-review of the literature

Envolvimentos do Sistema Nervoso Central na Síndrome de Lemierre: relato de caso e minirevisão da literatura

  • Feyzi Birol Sarica (1)
  • Kemal Kapanoglu (2)
  • Iskender Samet Daltaban (3)
  • Ilknur Senel (4)
  • Ilyas Tadayyon Einaddin Karakoc (2)
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Resumo

A síndrome de Lemierre é uma doença rara com curso fulminante observada em adultos jovens saudáveis. Após uma infecção orofaríngea, caracteriza-se por tromboflebite da veia jugular interna, septicemia e abscessos necróticos observados em órgãos distantes. O microrganismo causador é principalmente Fusobacterium necrophorum. A taxa de mortalidade nesses casos costumava ser em torno de 90% e hoje reduziu para 5% com o diagnóstico precoce e o tratamento antibiótico adequado. Embora a síndrome de Lemierre, descrita em 1936, tenha sido amplamente observada no período pré-antibiótico, o número de casos diminuiu drasticamente após o uso generalizado de antibióticos nas décadas de 1950 e 1960. Esta situação a levou a ser chamada de “doença esquecida” nos anos relevantes. Na década de 1970, observou-se que os casos de síndrome de Lemierre tendiam a aumentar segundo o avanço das técnicas de imagem radiológica. No entanto, as revisões feitas na literatura mostram que houve um aumento notável na incidência de casos de síndrome de Lemierre, principalmente nos últimos 15 anos. Neste artigo, foi apresentado um caso de Síndrome de Lemierre com sequelas de paralisia do nervo abducente esquerdo com revisão da literatura.

Palavras-chave

Necrobacilose humana; Trombose da veia jugular interna; Tromboflebite séptica jugular; Sepse pós-anginosa; Tromboflebite jugular supurativa

Abstract

Lemierre syndrome is a rare disease with fulminant course observed in healthy young adults. After an oropharyngeal infection, it is characterized by internal jugular vein thrombophlebitis, septicemia, and necrotic abscesses in distant organs. Mostly its causative microorganism is the Fusobacterium necrophorum. In these cases mortality rate used to be around 90%, but today this rate has decreased to 5% with early diagnosis and appropriate antibiotic treatment. Although the Lemierre syndrome, which was described in 1936, was widely observed in the pre-antibiotic period, the number of cases decreased dramatically after the widespread use of antibiotics in 1950s and 1960s. Facing this situation the Lemierre syndrome started being called the “forgotten disease” in the relevant years. In 1970s, it was observed its cases tended to increase according to the developments in radiological imaging techniques. Hovewer, the reviews in literature showed a remarkable increase in the incidence of Lemierre syndrome cases, especially in the last 15 years. In this  article, a case of Lemierre Syndrome with sequelae of left abducens nerve palsy was presented with a literature review.

Keywords

Human necrobacillosis; Internal jugular vein thrombosis; Jugular septic thrombophlebitis; Postanginal sepsis; Suppurative jugular thrombophlebitis

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1 MD, PhD, Associate Professor, Department of Neurosurgery, Giresun Education and Research Hospital, Medical School, University of Giresun, Giresun, Turkey.

2 MD, Department of Neurosurgery, Giresun Education and Research Hospital, Giresun, Turkey.

3 MD, Department of Neurosurgery, Trabzon Kanuni Education and Research Hospital, Trabzon, Turkey.

4 MD, PhD, Assistant Professor. Department of Infectious Diseases and Clinical Microbiology, University of Giresun Medical School, Giresun, Turkey.

 

Received Apr 30, 2022

Accepted May 15, 2022

JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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