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Clival osteomyelitis and hypoglossal nerve palsy--rare complications of Lemierre's syndrome.
- Source :
-
BMJ case reports [BMJ Case Rep] 2015 Aug 30; Vol. 2015. Date of Electronic Publication: 2015 Aug 30. - Publication Year :
- 2015
-
Abstract
- An increasingly reported entity, Lemierre's syndrome classically presents with a recent oropharyngeal infection, internal jugular vein thrombosis and the presence of anaerobic organisms such as Fusobacterium necrophorum. The authors report a normally fit and well 17-year-old boy who presented with severe sepsis following a 5-day history of a sore throat, myalgia and neck stiffness requiring intensive care admission. Blood cultures grew F. necrophorum and radiological investigations demonstrated left internal jugular vein, cavernous sinus and sigmoid sinus thrombus, left vertebral artery dissection and thrombus within the left internal carotid artery. Imaging also revealed two areas of acute ischaemia in the brain, consistent with septic emboli, skull base (clival) osteomyelitis and an extensive epidural abscess. The patient improved on meropenem and metronidazole and was warfarinised for his cavernous sinus thrombosis. He has an on-going left-sided hypoglossal (XIIth) nerve palsy.<br /> (2015 BMJ Publishing Group Ltd.)
- Subjects :
- Adolescent
Anti-Infective Agents administration & dosage
Anticoagulants administration & dosage
Cranial Fossa, Posterior pathology
Fever etiology
Fusobacterium Infections complications
Fusobacterium Infections drug therapy
Fusobacterium Infections physiopathology
Fusobacterium necrophorum drug effects
Humans
Hypoglossal Nerve Diseases drug therapy
Hypoglossal Nerve Diseases etiology
Hypoglossal Nerve Diseases physiopathology
Jugular Veins pathology
Lemierre Syndrome complications
Lemierre Syndrome drug therapy
Lemierre Syndrome physiopathology
Male
Meropenem
Metronidazole administration & dosage
Osteomyelitis drug therapy
Osteomyelitis etiology
Osteomyelitis physiopathology
Pharyngitis etiology
Sepsis drug therapy
Sepsis etiology
Thienamycins administration & dosage
Treatment Outcome
Warfarin administration & dosage
Fusobacterium Infections diagnosis
Fusobacterium necrophorum isolation & purification
Hypoglossal Nerve Diseases rehabilitation
Lemierre Syndrome diagnosis
Osteomyelitis diagnosis
Sepsis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 2015
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 26323975
- Full Text :
- https://doi.org/10.1136/bcr-2015-209777