DOI QR코드

DOI QR Code

Lemierre's Syndrome Originated from the Odontogenic Infection: A Case Report

  • Park, Chang-Joo (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Hwang, Kyung-Gyun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University) ;
  • Chang, Kun-Soo (Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University)
  • Received : 2012.06.12
  • Accepted : 2012.12.13
  • Published : 2012.12.30

Abstract

Also called necrobacillosis or postanginal sepsis, Lemierre's syndrome (LS) is an uncommon but potentially lethal complication of odontogenic infection. A 27-year-old male diagnosed with Ludwig's angina was transferred from a local hospital due to continuous fever and chills after incision and drainage under general anesthesia. The swelling of both submental and submandibular area subsided, but the fever and chills persisted. While generalized malaise improved, sepsis developed together with the deterioration of liver function. The chest computed tomography scan revealed multiple cavitations throughout both lungs, which were diagnosed as septic pulmonary embolism. After consulting the department of infectious diseases, the patient was treated with intravenous antibiotics focusing on vancomycin and additional antibiotics. After 3 weeks of treatment, the patient recovered completely. Despite its decreased mortality, dentists are not familiar with LS, and it is difficult to diagnose correctly. In this paper, we report a case and present a review of literature.

Keywords

References

  1. Albilia JB, Humber CC, Clokie CM, Sandor GK. Lemierre syndrome from an odontogenic source: a review for dentists. J Can Dent Assoc. 2010; 76: a47.
  2. Hagelskjaer Kristensen L, Prag J. Human necrobacillosis, with emphasis on Lemierre's syndrome. Clin Infect Dis. 2000; 31: 524-32. https://doi.org/10.1086/313970
  3. Eykyn SJ. Necrobacillosis. Scand J Infect Dis Suppl. 1989; 62: 41-6.
  4. Rosado P, Gallego L, Junquera L, de Vicente JC. Lemierre's syndrome: a serious complication of an odontogenic infection. Med Oral Patol Oral Cir Bucal. 2009; 14: e398-401.
  5. Serefhanoglu K, Bayindir Y, Ersoy Y, Isik K, Haciev liyagil SS, Serefhanoglu S. Septic pulmonary embolism secondary to dental focus. Quintessence Int. 2008; 39: 753-6.
  6. Dool H, Soetekouw R, van Zanten M, Grooters E. Lemierre's syndrome: three cases and a review. Eur Arch Otorhinolaryngol. 2005; 262: 651-4. https://doi.org/10.1007/s00405-004-0880-3
  7. Sinave CP, Hardy GJ, Fardy PW. The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (Baltimore). 1989; 68: 85-94.
  8. Riordan T, Wilson M. Lemierre's syndrome: more than a historical curiosa. Postgrad Med J. 2004; 80: 328-34. https://doi.org/10.1136/pgmj.2003.014274
  9. Le Moal G, Juhel L, Grollier G, Godet C, Azais I, Roblot F. Vertebral osteomyelitis due to Fusobacterium species: report of three cases and review of the literature. J Infect. 2005; 51: E5-9. https://doi.org/10.1016/j.jinf.2004.06.012
  10. Sonsale PD, Philipson MR, Bowskill J. Septic arthritis of the knee due to Fusobacterium necrophorum. J Clin Microbiol. 2004; 42: 3369-70. https://doi.org/10.1128/JCM.42.7.3369-3370.2004
  11. Shibasaki Warabi Y, Yoshikawa H, Idezuka J, Yamazaki M, Onishi Y. Cerebral infarctions and brain abscess due to Lemierre syndrome. Intern Med. 2005; 44: 653-6. https://doi.org/10.2169/internalmedicine.44.653
  12. Duquesne F, Milesi C, Guyon G, Saguintaah M, Chautemps N, Sabatier E, Cambonie G, Picaud JC. Fusobacterium necrophorum meningitis: forgotten complication of a gingivitis. Arch Pediatr. 2007; 14: 1000-2. https://doi.org/10.1016/j.arcped.2007.04.006
  13. Tan NC, Tan DY, Tan LC. An Unusual Headache: Lemierre's Syndrome. J Neurol. 2003; 250: 245-6. https://doi.org/10.1007/s00415-003-0964-9
  14. Juarez Escalona I, Diaz Carandell A, Aboul-Hons Centenero S, Monner Dieguez A, Mari Roig A, Arranz Obispo C, Piulachs Clapera P, Lluch Salas JM, Cusco Albors S, Sieira Gil R. Lemierre Syndrome associated with dental infections. Report of one case and review of the literature. Med Oral Patol Oral Cir Bucal. 2007; 12: E394-6.