(pictured left: image from NEJM...arrow pointing to a thrombosed jugular vein)Lemierre's Syndrome
What is it? a septic thrombus of the jugular vein.
Which bacteria are implicated? usually oral flora, and typically Fusobacterium species.
How does one get it? typically after acute pharyngitis, there may be a small abscess or erosion of the mucosa. Bacteria can then invade the peri-pharyngeal space which houses the carotid sheath (encasing the jugular vein), and neck musculature.
What is it? a septic thrombus of the jugular vein.
Which bacteria are implicated? usually oral flora, and typically Fusobacterium species.
How does one get it? typically after acute pharyngitis, there may be a small abscess or erosion of the mucosa. Bacteria can then invade the peri-pharyngeal space which houses the carotid sheath (encasing the jugular vein), and neck musculature.
How do patients present? more common in younger patients with a prodrome of a sore throat. They commonly have a fever, and possibly tenderness over the thrombosed vein. Septic emboli frequently spread to the lungs so an element of respiratory distress may be seen.
Treatment? use a beta-lactamase resistant beta-lactam. Surgical exploration may be required. The role of anticoagulation is controversial.
A great reference: check out this case
Treatment? use a beta-lactamase resistant beta-lactam. Surgical exploration may be required. The role of anticoagulation is controversial.
A great reference: check out this case
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