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Ophthalmic complications of Lemierre syndrome
- Source :
- Acta Ophthalmologica. 100
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- PURPOSE Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. METHODS We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (CRD42016052572). RESULTS Nine (33%) patients were women; the median age was 20 (Q1-Q3: 15-33) years. Fusobacterium spp. was involved in 56% of cases. The most prevalent initial manifestations were decreased vision (35%) and periocular oedema (38%), followed by impaired eye movements/nerve palsy (28%) and proptosis (28%). Venous involvement, notably cerebral vein thrombosis (70%) and ophthalmic vein thrombosis (55%), explained the symptomatology in most cases. Septic embolism (7%), orbital abscesses (2%) and carotid stenosis (14%) were also present. Ophthalmic sequelae were reported in 9 (33%) patients, often consisting of blindness or reduced visual acuity, and nerve paralysis/paresis. CONCLUSION Ophthalmic complications represent a severe manifestation of Lemierre syndrome, often reflecting an underlying cerebral vein thrombosis. Visual acuity loss and long-term severe complications are frequent. We call for an interdisciplinary approach to the management of patients with Lemierre syndrome and the routine involvement of ophthalmologists.
- Subjects :
- Adult
Male
10018 Ophthalmology Clinic
medicine.medical_specialty
Adolescent
Nerve Paralysis
610 Medizin
610 Medicine & health
Blindness
Young Adult
03 medical and health sciences
0302 clinical medicine
610 Medical sciences
medicine
Humans
Lemierre Syndrome
Child
Aged
Paresis
Septic embolism
Venous Thrombosis
biology
business.industry
Incidence
10031 Clinic for Angiology
General Medicine
Middle Aged
Mycotic aneurysm
2731 Ophthalmology
biology.organism_classification
medicine.disease
Surgery
Europe
Decreased vision
Ophthalmology
Stenosis
Fusobacterium
Child, Preschool
030221 ophthalmology & optometry
Female
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 17553768 and 1755375X
- Volume :
- 100
- Database :
- OpenAIRE
- Journal :
- Acta Ophthalmologica
- Accession number :
- edsair.doi.dedup.....24bcb575c3909df15abb2e5ee70b37e0