An Atypical Presentation of Lemierre’s Syndrome: Complicated by Thrombotic Thrombocytopenic Purpura
Aventura Hospital and Medical Center
thrombocytopenia, lemierre's syndrome, fusobacterium necrophorum, thrombotic thrombocytopenic purpura, lemierre, lemierre's
Bacterial Infections and Mycoses | Infectious Disease | Internal Medicine | Otorhinolaryngologic Diseases
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
Vera Nieves B, Lindblad G, Gupta J, et al. An Atypical Presentation of Lemierre’s Syndrome: Complicated by Thrombotic Thrombocytopenic Purpura. Cureus. 2021 Jan 15;13(1):e12728. doi:10.7759/cureus.12728