719A Rare Variant of Lemierre's Syndrome – Fusobacterium necrophorum Sepsis from Gynecological Origin
Year: 2014
Type: conference-abstract
Abstract: Background. Lemierre's syndrome is a rare, potentially severe disorder consisting of septic emboli from an internal jugular vein thrombus after oropharyngeal infection. There are a few case reports illustrating a variant of Lemierre's syndrome with the female genital tract being the source. Methods. Case report and review of the literature. A 19 year-old female presented with abdominal pain, nausea, vomiting and fever. The patient denied any sexually transmitted diseases or recent pregnancy. Besides severe pallor, no other focal signs were present on examination. Her laboratory values revealed severe microcytic anemia, thrombocytosis and leukocytosis with neutrophilic predominance. There were no signs of hemolysis. Abdominal and chest computerized tomography showed pelvic thrombophlebitis and ascites as well as "septic" pulmonary emboli. Admission blood cultures grew Fusobacterium necrophorum on day three. As there was no evidence of infection or thrombophlebitis in the head and neck region, a more detailed sexual history was taken by a female medical resident and the patient revealed she was recently pregnant and had an abortion (not done by a medical professional). Keeping in mind her recent history of septic abortion and Fusobacterium sp. being a common commensal of the female genitourinary tract, a diagnosis of Lemierre's syndrome was made. The patient improved with ampicillin/sulbactam. As our patient had extensive thrombosis extending to inferior vena cava with septic emboli, she was started on anticoagulation. Results. Lemierre's syndrome is a rare, well described entity that usually follows infection of oropharyngeal structures associated with thrombus formation in adjacent veins and septic emboli to the lungs. Though oropharyngeal structures are the most common source, Fusobacterium sp. can originate from the female genitourinary tract and may have similar clinical picture with the exception of the site of thrombosis and presenting complaints. Conclusion. This case report illustrates a pelvic variant of Lemierre's syndrome. Disclosures. All authors: No reported disclosures.
Source: Open Forum Infectious Diseases
Authors: Shivani Garg, Jorge Mora, Glenn Eiger
Institution: Jefferson Einstein Philadelphia Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2285365897