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Lemierre's syndrome associated with consumption coagulopathy and acute renal failure: a case report

Published online by Cambridge University Press:  15 May 2007

S Georgopoulos ,
S Korres ,
M Riga ,
D Balatsouras ,
G Kotsis  and
E Ferekidis
S Georgopoulos
Affiliation:
ENT Department, Elpis General Hospital, Athens, Greece
S Korres
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
M Riga*
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
D Balatsouras
Affiliation:
ENT Department, Tzanion General Hospital, Piraeus Greece
G Kotsis
Affiliation:
Internal Medicine Department, Elpis General Hospital, Athens, Greece
E Ferekidis
Affiliation:
ENT Department, Athens University, Hippokration Hospital, Athens, Greece
*
Address for correspondence: Maria Riga, 7 Athenas str, 54634 Thessaloniki, Greece. Fax: 0030 210 8136971 E-mail: mariariga@hotmail.com
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Abstract

Background:

Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.

Case report:

The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.

Conclusion:

The usual causative pathogen, namely Fusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.

Keywords

Lemierre's SyndromeTonsillitisHaemolytic Uraemic Syndrome

Information

Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 527 - 530
Copyright
Copyright © JLO (1984) Limited 2007

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