Retrofarengeal ve Mediastinal Abse ile Sonuçlanan Lemierre Sendromu

Year 2022, , 410 - 412, 01.03.2022

Ahmet Aksoy , Fatih Bingöl Alper Kızıloğlu

https://doi.org/10.28982/josam.867640

Abstract

Genelde orofarengeal bir enfeksiyonu takiben gelişen internal juguler venin septik tromboflebitiyle tanımlanan lemierre sendromu yaygın olarak sağlıklı gençlerde veya genç yetişkinlerde gözlenmektedir. Yeni Koronavirüs Hastalığı (COVID-19) semptomatolojisi nedeniyle başvuran her hastanın COVID-19 olası vaka olarak başlangıçta değerlendirildiği, 23 yaşında erkek hastada gelişen retrofarengeal ve mediastinal absenin cerrahi ve medikal müdahelerle başarılı bir şekilde tedavisi yapıldı. Başlangıçta olası COVID-19 olarak değerlendirilen ve takip edilen ancak sonrasında ekarte edilen bu ön tanısı, retrofarengeal den başlayıp mediastene uzanan absesi olan lemierre sendromlu olgumuzun tanı ve tedavisini literatürü gözüyle sunmayı amaçladık.

Keywords

Lemierre sendromu,, İnternal juguler ven, Retrofarengeal abse, COVID-19

A complex case of retropharyngeal and mediastinal abscess during the Covid-19 pandemic: Lemierre's syndrome

Abstract

Lemierre’s syndrome, which is commonly observed in healthy adolescents and young adults, is characterized by septic thrombophlebitis of the internal jugular vein and is usually observed after an oropharyngeal infection. At the time of the pandemic, as a result of so many patients COVID-19, similar symptoms were initially diagnosed as a possible coronavirus case and followed up with a possible diagnosis of COVID-19 before being consulted. We present the case of a 23-year-old male patient, who was referred to our clinic with complaints of fever, sore throat, dysphagia, shortness of breath, and chest pain. A retropharyngeal and mediastinal abscess occurred after these symptoms were successfully treated with surgical and medical interventions. The patient was initially considered a potential case of COVID-19 and followed as such. COVID-19 was then excluded, and the patient was reported to have an abscess extending from the retropharyngeal area to the mediastinum. We aim to present the diagnosis and treatment of Lemierre’s syndrome based on a literature review.

Keywords

Lemierre’s syndrome, Internal jugular vein, Retropharyngeal abscess, COVID-19

References

• 1. Lovato A, de Filippis C. Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms. Ear Nose Throat J. 2020 Nov;99(9):569-76. doi: 10.1177/0145561320920762.
• 2. Lovato A, Rossettini G, de Filippis C. Sore throat in COVID-19: Comment on "Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis". J Med Virol. 2020 Jul;92(7):714-5. doi: 10.1002/jmv.25815.
• 3. Kuppalli K, Livorsi D, Talati NJ, Osborn M. Lemierre's syndrome due to Fusobacterium necrophorum. Lancet Infect Dis. 2012 Oct;12(10):808-15. doi: 10.1016/S1473-3099(12)70089-0.
• 4. Creemers-Schild D, Gronthoud F, Spanjaard L, Visser LG, Brouwer CN, Kuijper EJ. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections? New Microbes New Infect. 2014 May;2(3):52-7. doi: 10.1002/nmi2.39.
• 5. Kliegman RM, Lye PS, Bordini BJ, Toth H, Basel D, Editor (s). Nelson Pediatric Symptom-Based Diagnosis. Tanz RR. Section 1-Respiratory Disorders, Sore Throat. Elsevier, 2018, Pages 1-20, ISBN 978-0-323-39956-2
• 6. Surapaneni BK, Omar H, Iguina MM, Suarez M. Fusobacterium necrophorum Septicemia Leading to Lemierre's Syndrome in an Immunocompetent Individual: A Case Report. Cureus. 2020 Mar 28;12(3):e7443. doi: 10.7759/cureus.7443.
• 7. Siddique MK, Chang G, Lagmay V, Shih M. Lemierre's syndrome caused by Streptococcus pyogenes in an elderly woman. J Vasc Surg Cases Innov Tech. 2020 Feb 4;6(1):31-3. doi: 10.1016/j.jvscit.2019.11.007.
• 8. Moore BA, Dekle C, Werkhaven J. Bilateral Lemierre's syndrome: a case report and literature review. Ear Nose Throat J. 2002 Apr;81(4):234-6, 238-40, 242 passim.
• 9. Johannesen KM, Bodtger U. Lemierre's syndrome: current perspectives on diagnosis and management. Infect Drug Resist. 2016 Sep 14;9:221-7. doi: 10.2147/IDR.S95050.
• 10. Ridgway JM, Parikh DA, Wright R, Holden P, Armstrong W, Camilon F, et al. Lemierre syndrome: a pediatric case series and review of literature. Am J Otolaryngol. 2010 Jan-Feb;31(1):38-45. doi: 10.1016/j.amjoto.2008.09.006.