An Atypical Presentation of Lemierre’s Syndrome: Complicated by Thrombotic Thrombocytopenic Purpura

Division

East Florida

Hospital

Aventura Hospital and Medical Center

Document Type

Abstract

Publication Date

1-15-2020

Keywords

thrombocytopenia, lemierre's syndrome, fusobacterium necrophorum, thrombotic thrombocytopenic purpura, lemierre, lemierre's

Disciplines

Bacterial Infections and Mycoses | Infectious Disease | Internal Medicine | Otorhinolaryngologic Diseases

Abstract

Lemierre’s syndrome is an oropharyngeal infection complicated by septic thrombophlebitis of the internal jugular vein, bacteremia, and septic emboli. It mainly occurs in immunocompetent individuals and was first reported in the early 1900s by physician Andre Lemierre. A 23-year-old male presented to our institution with sore throat, difficulty swallowing, left-sided ear pain, nausea, vomiting, subjective fevers, general malaise, right-sided rib pain, and anorexia. Complete blood cell count and metabolic panels revealed severe thrombocytopenia, mild anemia, acute kidney injury, and hyperbilirubinemia. Blood cultures grew Fusobacterium necrophorum. Ultrasound and computed tomography scan of the neck revealed thrombosis of the left internal jugular vein. ADAMTS13 activity was later reported to be markedly decreased at less than 2%, confirming a diagnosis of thrombotic thrombocytopenic purpura.

Publisher or Conference

Cureus

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