Lemierre's syndrome and right adnexal abscess; A Case Report and Review of the Literature

Year 2014, , 114 - 117, 01.09.2014

Malak Alhakeem Thomas Schneider Thomas Cronen Cronen Thomas Ilmi Behluli

https://doi.org/10.5799/ahinjs.02.2014.03.0151

Cited By: 1

Abstract

Lemierre\'s syndrome is an extremely rare but a completely curable condition. A high index of suspicion is needed for early diagnosis and proper treatment. We report a 20 year old virgin Caucasian lady presented with sore throat, fever, neck pain, nausea and vomiting followed by acute abdomen. Her laboratory investigations revealed white blood count 13,300/mm3, C-reactive protein 332 mg/L. Abdominal computed tomography scan showed pelvic abscess 6.2 x 6.1 cm mainly involving the right ovary. Intra-abdominal swab showed growth of Fusobactrerium necrophorum. Right adnexectomy and proper antibiotic was carried out. High index of doubt is the most important key in diagnosing this fatal syndrome. In our case the diagnosis of the syndrome was made only after the isolation of F. necrophorum from the intra-abdominal swab culture.

Keywords

Lemierre’s syndrome; adnexal abscess; virgin

Lemierre's syndrome and right adnexal abscess; A Case Report and Review of the Literature

Abstract

Lemierre sendromu çok nadir görülen ve tamamen tedavi edilebilen bir durumdur. Erken tanı ve uygun tedavi için çok erkenden şüphelenmek gerekmektedir. Burada boğaz ağrısı, ateş, boyun ağrısı, karın ağrısını takip eden bulantı ve kusmayla başvuran 20 yaşında evlenmemiş beyaz bir kadını rapor ettik. Laboratuvar testlerinde beyaz kan hücre sayısı 13.300/mm3, C-reaktif protein değeri 332 mg/L idi. Batın bilgisayarlı tomografi incelemesinde başlıca sağ overi tutan 6,2 x 6,1 cm boyutlarında pelvik abse görüldü. Karın içinden alınan sürüntü kültüründen Fusobacterium necrophorum üremesi oldu. Sağ adneksektomi ve uygun antibiyotikle iyileşti. Bu öldürücü sendromun tanısında erken dönemde şüphelenme en önemli anahtar rolünü oynamaktadır. Bizim olgumuzda tanı F. necrophorum’un batın sürüntü kültüründen izolasyonu ile konuldu.Anahter kelimeler: Lemierre sendromu, adneks absesi, bakire

Keywords

-

References

• Riordan T. Human infection with Fusobacterium necrophorum (Necrobacillosis), with a focus on Lemierre’s syndrome. Clin Microbiol 2007; Rev 20:622-659.
• Lemierre A. On certain septicemias due to anaerobic organ- isms. Lancet 1936;1:701-703.
• Hirschel B, Allaz AF, Siegrist CA. Anaerobic septicemia follow- ing oropharyngeal infections (Lemierre’s postanginal septi- cemia): a forgotten syndrome. Schweiz Med Wochenschr 1983;113:2008-2011.
• Iwasaki T, Yamamoto T, Inoue K, Takaku K. A case of Lemierre’s syndrome in association with liver abscess without any other metastatic lesions. Intern Med 2012;51:1419-1423.
• Shah SA, Ghani R. Lemierre’s syndrome: a forgotten com- plication of oropharyngeal infection. J Ayub Med Coll Abot- tabad 2005;17:30-33.
• Chayachinda C, Leelaporn A, Ruangvutilert P, Thamkhan- tho M. Post-partum, post-sterilization tubo-ovarian abscess caused by Fusobacterium necrophorum: a case report. J Med Case Rep 2012;6:330.
• Mehta N, Aisenberg G. Necrobacillosis without Lemierre’s syn- drome. Lancet 2006; 367:1702.
• Alston JM. Necrobacillosis in Great Britain. Br Med J 1955;2:1524-1528.
• Hagelskjaer LH, Prag J, Malczynski J, Kristensen JH. Inci- dence and clinical epidemiology of necrobacillosis, including Lemierre’s syndrome, in Denmark 1990-1995. Eur J Clin Mi- crobiol Infect Dis 1998;17:561-565.
• Goodwin K, Fleming N, Dumont T. Tubo-ovarian abscess in virginal adolescent females: A case report and review of the literature. J Pediatr Adolesc Gynecol 2013;26: e99-e102.