Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review
Background: Lemierre syndrome is a rare, potentially fatal complication of oropharyngeal infections characterized by septic thrombophlebitis of the internal jugular vein. It primarily affects healthy adolescents and young adults. Its incidence declined after the antibiotic era, but it may have resur...
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MDPI AG
2024-03-01
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| Series: | Pediatric Reports |
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| Online Access: | https://www.mdpi.com/2036-7503/16/1/18 |
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| author | Salvatore Lavalle Edoardo Masiello Salvatore Cocuzza Piero Pavone Alessandra Di Nora Christian Calvo-Henriquez Jerome Rene Lechien Miguel Mayo Yanez Andrea Praticò Manuela Ceccarelli Giannicola Iannella Annalisa Pace Federica Maria Parisi Giuseppe Magliulo Antonino Maniaci |
| author_facet | Salvatore Lavalle Edoardo Masiello Salvatore Cocuzza Piero Pavone Alessandra Di Nora Christian Calvo-Henriquez Jerome Rene Lechien Miguel Mayo Yanez Andrea Praticò Manuela Ceccarelli Giannicola Iannella Annalisa Pace Federica Maria Parisi Giuseppe Magliulo Antonino Maniaci |
| author_sort | Salvatore Lavalle |
| collection | DOAJ |
| description | Background: Lemierre syndrome is a rare, potentially fatal complication of oropharyngeal infections characterized by septic thrombophlebitis of the internal jugular vein. It primarily affects healthy adolescents and young adults. Its incidence declined after the antibiotic era, but it may have resurged in recent decades, likely due to judicious antibiotic use and increasing bacterial resistance. Prompt diagnosis and treatment are imperative to prevent significant morbidity and mortality. Methods: Lemierre syndrome has been called “the forgotten disease,” with a reported incidence of around 3.6 cases per million. The mean age at presentation is around 20 years old, though it can occur at any age. Lemierre Syndrome follows an oropharyngeal infection, most commonly pharyngitis, leading to septic thrombophlebitis of the internal jugular vein. <i>F. necrophorum</i> is the classic pathogen, though other organisms are being increasingly isolated. Metastatic infections, especially pulmonary, are common complications. Contrast-enhanced CT of the neck confirming internal jugular vein thrombosis is the gold standard for diagnosis. Long-course broad-spectrum IV antibiotics covering anaerobes are the mainstays of the disease’s treatment. Anticoagulation may also be considered. Mortality rates are high without treatment, but most patients recover fully with appropriate therapy. Conclusions: Lemierre syndrome should be suspected in patients with prolonged pharyngitis followed by unilateral neck swelling and fevers. Early diagnosis and prompt antibiotic therapy are key, given the potential for disastrous outcomes if untreated. An increased awareness of Lemierre syndrome facilitates its timely management. |
| first_indexed | 2024-04-24T17:55:47Z |
| format | Article |
| id | doaj.art-176a64d7a6ba49ca8680385abde2d384 |
| institution | Directory Open Access Journal |
| issn | 2036-7503 |
| language | English |
| last_indexed | 2024-04-24T17:55:47Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pediatric Reports |
| spelling | doaj.art-176a64d7a6ba49ca8680385abde2d3842024-03-27T13:59:07ZengMDPI AGPediatric Reports2036-75032024-03-0116120121310.3390/pediatric16010018Pediatric Lemierre’s Syndrome: A Comprehensive Literature ReviewSalvatore Lavalle0Edoardo Masiello1Salvatore Cocuzza2Piero Pavone3Alessandra Di Nora4Christian Calvo-Henriquez5Jerome Rene Lechien6Miguel Mayo Yanez7Andrea Praticò8Manuela Ceccarelli9Giannicola Iannella10Annalisa Pace11Federica Maria Parisi12Giuseppe Magliulo13Antonino Maniaci14Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, ItalyRadiology Unit, Department Clinical and Experimental, Experimental Imaging Center, Vita-Salute San Raffaele University, 20132 Milan, ItalyDepartment of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95123 Catania, ItalyDepartment of Child and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95100 Catania, ItalyDepartment of Child and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95100 Catania, ItalyService of Otolaryngology, Hospital Complex of Santiago de Compostela, 15701 Santiago de Compostela, SpainHead and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, FranceHead and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, FranceFaculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, ItalyFaculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, ItalyDepartment of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, ItalyDepartment of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, ItalyDepartment of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95123 Catania, ItalyDepartment of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, ItalyFaculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, ItalyBackground: Lemierre syndrome is a rare, potentially fatal complication of oropharyngeal infections characterized by septic thrombophlebitis of the internal jugular vein. It primarily affects healthy adolescents and young adults. Its incidence declined after the antibiotic era, but it may have resurged in recent decades, likely due to judicious antibiotic use and increasing bacterial resistance. Prompt diagnosis and treatment are imperative to prevent significant morbidity and mortality. Methods: Lemierre syndrome has been called “the forgotten disease,” with a reported incidence of around 3.6 cases per million. The mean age at presentation is around 20 years old, though it can occur at any age. Lemierre Syndrome follows an oropharyngeal infection, most commonly pharyngitis, leading to septic thrombophlebitis of the internal jugular vein. <i>F. necrophorum</i> is the classic pathogen, though other organisms are being increasingly isolated. Metastatic infections, especially pulmonary, are common complications. Contrast-enhanced CT of the neck confirming internal jugular vein thrombosis is the gold standard for diagnosis. Long-course broad-spectrum IV antibiotics covering anaerobes are the mainstays of the disease’s treatment. Anticoagulation may also be considered. Mortality rates are high without treatment, but most patients recover fully with appropriate therapy. Conclusions: Lemierre syndrome should be suspected in patients with prolonged pharyngitis followed by unilateral neck swelling and fevers. Early diagnosis and prompt antibiotic therapy are key, given the potential for disastrous outcomes if untreated. An increased awareness of Lemierre syndrome facilitates its timely management.https://www.mdpi.com/2036-7503/16/1/18Lemierre’s syndromeneck abscessinternal jugular vein thrombophlebitisseptic thrombophlebitispediatric |
| spellingShingle | Salvatore Lavalle Edoardo Masiello Salvatore Cocuzza Piero Pavone Alessandra Di Nora Christian Calvo-Henriquez Jerome Rene Lechien Miguel Mayo Yanez Andrea Praticò Manuela Ceccarelli Giannicola Iannella Annalisa Pace Federica Maria Parisi Giuseppe Magliulo Antonino Maniaci Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review Pediatric Reports Lemierre’s syndrome neck abscess internal jugular vein thrombophlebitis septic thrombophlebitis pediatric |
| title | Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review |
| title_full | Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review |
| title_fullStr | Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review |
| title_full_unstemmed | Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review |
| title_short | Pediatric Lemierre’s Syndrome: A Comprehensive Literature Review |
| title_sort | pediatric lemierre s syndrome a comprehensive literature review |
| topic | Lemierre’s syndrome neck abscess internal jugular vein thrombophlebitis septic thrombophlebitis pediatric |
| url | https://www.mdpi.com/2036-7503/16/1/18 |
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