Lemierre syndrome is a rare but serious complication of untreated throat or tonsil infections, caused by bacteria such as Fusobacterium necrophorum. Symptoms include sore throat, fever, neck tenderness, and clotting leading to weakness and fainting. Treatment involves antibiotics, blood thinners, and possible surgery. Early diagnosis and treatment is crucial for a full recovery.
Lemierre syndrome is a possible complication of a serious, untreated infection of the throat or tonsils. It is more common in otherwise healthy adolescents and young adults. The problems occur when bacteria begin to thrive inside the abscesses in the throat, leading to deep-seated infections that can reach a major blood vessel called the jugular vein. If the vein is compromised, it can lead to dangerous blood clotting and tissue death in the respiratory tract. Most cases of Lemierre syndrome can be cured with antibiotics if the condition is discovered and treated right away.
Several types of bacteria can lead to Lemierre syndrome, but the most common culprit is Fusobacterium necrophorum (F. necrophorum). The bacteria attach themselves to the walls of the pharynx and eventually create an abscess. F. necrophorum reaching the jugular vein trigger a clotting response that severely restricts blood flow from the head to the heart. When the clot naturally begins to break down, the infected blood travels to the lungs and throughout the body.
Early symptoms of Lemierre syndrome typically include a worsening sore throat, low-grade fever, and tenderness in the front and side of the neck. Flu-like symptoms of joint pain and fatigue can occur as the infection begins to spread. Clotting can lead to extreme weakness, lightheadedness, and fainting. Shallow breathing and a slow heart rate are signs that the infection has reached the lungs.
A doctor can diagnose Lemierre syndrome by examining your symptoms, doing diagnostic scans of your neck, and analyzing laboratory results of blood tests. Computed tomography and ultrasound of the neck reveal extensive inflammation of the pharynx and blood clotting in the jugular vein. If the infection has spread to the lungs or lymph nodes, imaging tests can be used to assess the extent of the damage. Blood cultures positive for F. necrophorum help confirm the diagnosis. Patients are usually hospitalized so that doctors can monitor changes in their symptoms and determine the best course of treatment.
Treatment for Lemierre syndrome depends on the severity of the infection. Many cases can be managed with a long course of intravenous antibiotics. Blood thinners may also be given to break up existing clots and reduce the risk of future blockages. If the jugular vein is badly damaged, it may need to be removed or bypassed using a large blood vessel transplant. Other surgeries or clinical procedures may be considered if the infection spreads. Most patients who receive treatment in the early stages of Lemierre syndrome are able to recover completely in about two months.
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