Lemierre Syndrome

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Lemierre syndrome is a complicated neck infection which include septic thrombosis of the jugular vein.

Lemierre syndrome typical starts as pharyngitis in older children and progresses to jugular vein septic thrombosis and pulmonary embolic disease. Fusobacterium spp. especially F necrophorum are the most common pathogens. Other potential organisms either alone or in mixed infections include other anaerobic bacteria, staphylococci (including MRSA) and streptococci.

Treatment should have good anaerobic coverage and a variety of regimens are reported. Anticoagulation may be needed.

References:

Ridgway JM, Parikh DA, Wright R, Holden P, Armstrong W, Camilon F, Wong BJ. Lemierre syndrome: a pediatric case series and review of literature. Am J Otolaryngol. 2010 Jan-Feb;31(1):38-45. PMID: 19944898

Bradly JS (ed.) (2018) Nelson's Pediatric Antimicrobial Therapy 24th edition. Itasca, IL:American Academy of Pediatrics