Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans

Background. Lemierre’s syndrome is a rare condition of internal jugular vein thrombosis following oropharyngeal infection. While it usually results from Fusobacterium necrophorum infection, atypical cases associated with other pathogens have been reported. Objective. To describe a unique case of ped...

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Autores principales:	Samantha Novotny, Kenneth Serrano, Danielle Bazer, Louis Manganas
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/18286622ff0b428a94fd43313cdd2d68
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spelling	oai:doaj.org-article:18286622ff0b428a94fd43313cdd2d682021-11-08T02:35:34ZMultiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans2090-667610.1155/2021/4455789https://doaj.org/article/18286622ff0b428a94fd43313cdd2d682021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/4455789https://doaj.org/toc/2090-6676Background. Lemierre’s syndrome is a rare condition of internal jugular vein thrombosis following oropharyngeal infection. While it usually results from Fusobacterium necrophorum infection, atypical cases associated with other pathogens have been reported. Objective. To describe a unique case of pediatric Lemierre’s syndrome with Streptococcus viridans infection resulting in cavernous sinus thrombosis and oculomotor, trochlear, and abducens nerve palsies. Case Report. A 14-year-old female initially presented after six days of fever, myalgias, and sore throat and was admitted for hyperbilirubinemia and acute kidney injury. She developed a fixed, dilated pupil with complete ophthalmoplegia, ptosis, and severe pain. Imaging revealed retromandibular space abscess, external and internal jugular vein thrombosis, cavernous sinus thrombosis, internal carotid artery stenosis, pulmonary embolism, and bilateral pneumonia. She was diagnosed with Lemierre’s syndrome with cultures positive for Streptococcus viridans and treated with a combination of antibiotics and anticoagulation. Conclusion and Relevance. Both antibiotics and anticoagulation were effective management for this Lemierre’s syndrome patient with cavernous sinus thrombosis. Early diagnosis and treatment of Lemierre’s syndrome is essential. A multidisciplinary treatment team is beneficial for managing the sequelae of this condition.Samantha NovotnyKenneth SerranoDanielle BazerLouis ManganasHindawi LimitedarticleNeurology. Diseases of the nervous systemRC346-429ENCase Reports in Neurological Medicine, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Samantha Novotny Kenneth Serrano Danielle Bazer Louis Manganas Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
description	Background. Lemierre’s syndrome is a rare condition of internal jugular vein thrombosis following oropharyngeal infection. While it usually results from Fusobacterium necrophorum infection, atypical cases associated with other pathogens have been reported. Objective. To describe a unique case of pediatric Lemierre’s syndrome with Streptococcus viridans infection resulting in cavernous sinus thrombosis and oculomotor, trochlear, and abducens nerve palsies. Case Report. A 14-year-old female initially presented after six days of fever, myalgias, and sore throat and was admitted for hyperbilirubinemia and acute kidney injury. She developed a fixed, dilated pupil with complete ophthalmoplegia, ptosis, and severe pain. Imaging revealed retromandibular space abscess, external and internal jugular vein thrombosis, cavernous sinus thrombosis, internal carotid artery stenosis, pulmonary embolism, and bilateral pneumonia. She was diagnosed with Lemierre’s syndrome with cultures positive for Streptococcus viridans and treated with a combination of antibiotics and anticoagulation. Conclusion and Relevance. Both antibiotics and anticoagulation were effective management for this Lemierre’s syndrome patient with cavernous sinus thrombosis. Early diagnosis and treatment of Lemierre’s syndrome is essential. A multidisciplinary treatment team is beneficial for managing the sequelae of this condition.
format	article
author	Samantha Novotny Kenneth Serrano Danielle Bazer Louis Manganas
author_facet	Samantha Novotny Kenneth Serrano Danielle Bazer Louis Manganas
author_sort	Samantha Novotny
title	Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
title_short	Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
title_full	Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
title_fullStr	Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
title_full_unstemmed	Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans
title_sort	multiple cranial nerve palsies in a pediatric case of lemierre’s syndrome due to streptococcus viridans
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/18286622ff0b428a94fd43313cdd2d68
work_keys_str_mv	AT samanthanovotny multiplecranialnervepalsiesinapediatriccaseoflemierressyndromeduetostreptococcusviridans AT kennethserrano multiplecranialnervepalsiesinapediatriccaseoflemierressyndromeduetostreptococcusviridans AT daniellebazer multiplecranialnervepalsiesinapediatriccaseoflemierressyndromeduetostreptococcusviridans AT louismanganas multiplecranialnervepalsiesinapediatriccaseoflemierressyndromeduetostreptococcusviridans
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Multiple Cranial Nerve Palsies in a Pediatric Case of Lemierre’s Syndrome due to Streptococcus viridans

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