Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report

Abstract Background Lemierre syndrome (LS) is characterized by multisystemic infection beginning in the oropharynx, local thrombophlebitis (typically, of the internal jugular vein) and peripheral embolism. No evidence-based guidelines exist for the management of this disease, and the use of anticoag...

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Autores principales:	Jie Ge, Peipei Zhou, Yifei Yang, Tianshu Xu, Xu Yang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Anticoagulation Infectious disease Thromboembolism Lemierre syndrome Case report Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/ffbfa6a9ede84fdb8c6693f01c07bbbf
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spelling	oai:doaj.org-article:ffbfa6a9ede84fdb8c6693f01c07bbbf2021-11-08T10:58:46ZAnticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report10.1186/s12959-021-00336-01477-9560https://doaj.org/article/ffbfa6a9ede84fdb8c6693f01c07bbbf2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12959-021-00336-0https://doaj.org/toc/1477-9560Abstract Background Lemierre syndrome (LS) is characterized by multisystemic infection beginning in the oropharynx, local thrombophlebitis (typically, of the internal jugular vein) and peripheral embolism. No evidence-based guidelines exist for the management of this disease, and the use of anticoagulation therapy remains particularly controversial. Case presentation A 61-year-old man presenting with left neck swelling, odynophagia, and dyspnea underwent emergency surgery and received intravenous antibiotics. The primary infection was controlled on hospital day 5, but on day 6 sudden leukocytosis and hypoxemia were observed. CT angiography revealed an intraluminal filling defect in the pulmonary artery on day 8. LS was diagnosed and anticoagulation therapy was initiated. The WBC count, which had maintained its peak values in the previous 2 days, decreased instantly after initiation, and follow-up controls showed thrombus resolution. Conclusions Our case supports the notion that anticoagulation therapy may be a valid supplement to antimicrobial therapy in LS, especially in the presence of a possibly young thrombus as suggested by clinical worsening.Jie GePeipei ZhouYifei YangTianshu XuXu YangBMCarticleAnticoagulationInfectious diseaseThromboembolismLemierre syndromeCase reportDiseases of the blood and blood-forming organsRC633-647.5ENThrombosis Journal, Vol 19, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anticoagulation Infectious disease Thromboembolism Lemierre syndrome Case report Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Anticoagulation Infectious disease Thromboembolism Lemierre syndrome Case report Diseases of the blood and blood-forming organs RC633-647.5 Jie Ge Peipei Zhou Yifei Yang Tianshu Xu Xu Yang Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
description	Abstract Background Lemierre syndrome (LS) is characterized by multisystemic infection beginning in the oropharynx, local thrombophlebitis (typically, of the internal jugular vein) and peripheral embolism. No evidence-based guidelines exist for the management of this disease, and the use of anticoagulation therapy remains particularly controversial. Case presentation A 61-year-old man presenting with left neck swelling, odynophagia, and dyspnea underwent emergency surgery and received intravenous antibiotics. The primary infection was controlled on hospital day 5, but on day 6 sudden leukocytosis and hypoxemia were observed. CT angiography revealed an intraluminal filling defect in the pulmonary artery on day 8. LS was diagnosed and anticoagulation therapy was initiated. The WBC count, which had maintained its peak values in the previous 2 days, decreased instantly after initiation, and follow-up controls showed thrombus resolution. Conclusions Our case supports the notion that anticoagulation therapy may be a valid supplement to antimicrobial therapy in LS, especially in the presence of a possibly young thrombus as suggested by clinical worsening.
format	article
author	Jie Ge Peipei Zhou Yifei Yang Tianshu Xu Xu Yang
author_facet	Jie Ge Peipei Zhou Yifei Yang Tianshu Xu Xu Yang
author_sort	Jie Ge
title	Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
title_short	Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
title_full	Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
title_fullStr	Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
title_full_unstemmed	Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report
title_sort	anticoagulation may contribute to antimicrobial treatment of lemierre syndrome: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ffbfa6a9ede84fdb8c6693f01c07bbbf
work_keys_str_mv	AT jiege anticoagulationmaycontributetoantimicrobialtreatmentoflemierresyndromeacasereport AT peipeizhou anticoagulationmaycontributetoantimicrobialtreatmentoflemierresyndromeacasereport AT yifeiyang anticoagulationmaycontributetoantimicrobialtreatmentoflemierresyndromeacasereport AT tianshuxu anticoagulationmaycontributetoantimicrobialtreatmentoflemierresyndromeacasereport AT xuyang anticoagulationmaycontributetoantimicrobialtreatmentoflemierresyndromeacasereport
_version_	1718442489079136256

Anticoagulation may contribute to antimicrobial treatment of Lemierre syndrome: a case report

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