Lemierre’s syndrome in a pediatric patient with otomastoiditis caused by Streptococcus anginosus: A case report

Authors

DOI:

https://doi.org/10.33448/rsd-v13i12.47915

Keywords:

Lemierre's syndrome; Streptococcus anginosus; Internal jugular vein; Otomastoiditis; Thrombophlebitis.

Abstract

Lemierre's syndrome is a rare disease characterized by complications secondary to oropharyngeal infection, including septic thrombophlebitis, with the internal jugular vein (IJV) being the most common site of involvement. It can also lead to septic emboli formation in other locations. First reported in 1936, its incidence has increased in recent years. Treatment includes antibiotic therapy, with no consensus in the literature regarding anticoagulation or surgical intervention, which should be evaluated on a case-by-case basis. The purpose of this report is to highlight the rare presentation of the syndrome in pediatric patients, providing a detailed description of clinical progression, complications, and treatment adopted. Additionally, it aims to contribute to the monitoring of complications in pediatric patients initially diagnosed with common conditions. This paper discusses the clinical case of a 5-year and 5-month-old male pediatric patient initially diagnosed with acute otitis media, progressing to otomastoiditis caused by Streptococcus anginosus. During hospitalization, he developed septic arthritis in the left hip, pleural effusion, IJV thrombosis, and sigmoid sinus thrombosis, characteristic findings of Lemierre's syndrome.

References

Abhishek, A., Sandeep, S. & Tarun, P. (2013). Lemierre syndrome from a neck abscess due to methicillin-resistant Staphylococcus aureus. Braz J Infect Dis., 17(4), 507–509.

Adedeji, A. et al. (2021). Anticoagulation strategies in the management of Lemierr syndrome: a systematic review of the literature. Ann Pharmacother, 55(5), 658–665.

Amarnani, S. & Ranjan, A. (2022). Lemierre's Syndrome: A Lethal Complication of Acute Tonsillitis. Cureus, 14(10), e30072.

Asam, D. & Spellerberg, B. (2014). Molecular pathogenicity of Streptococcus anginosus. Molecular Oral Microbiology, 29, 145–155.

Berardinelli, E., Rosanova, M. & Lopardo, H. (2021). Estreptococos del grupo Streptococcus anginosus Parte IIIa. Epidemiología e infecciones de cabeza y cuello. Acta Bioquímica Clínica Latinoamericana, 55(2), 177-189.

Elibert, W. & Singla, N. (2013). Lemierre’s Syndrome. International Journal of Emergency Medicine, 6(40).

Fu, K. et al. (2024). Streptococcus anginosus promotes gastric inflammation, atrophy, and tumorigenesis in mice. Cell, 187, 882-896.

Golpe, R., Marín, B. & Alonso, M. (1999). Lemierre’s syndrome (necrobacillosis). Postgrad Med J., 75, 141–144.

Gore, M. (2020). Lemierre Syndrome: A Meta-analysis. Int Arch Otorhinolaryngol., 24(3), 379-385.

Hemani, F. et al. (2022). Lemierre’s syndrome in a child. Pak J Med Sci, 38(2), 433-435.

Jena, N., Yella, P. R. & Chandramohan, D. (2023). Lemierre’s Syndrome Due to Streptococcus anginosus: A Case Report and Review of the Literature. Cureus, 15(8), e44311.

Jensen, A., Hoshino, T. & Kilian, M. (2013). Taxonomy of the Anginosus group of the genus Streptococcus and description of Streptococcus anginosus subsp. whileyi subsp. nov. and Streptococcus constellatus subsp. viborgensissubsp. nov. Int. J. Syst. Evol. Microbiol., 63, 2506–2519.

Lee, W. et al. (2020). Lemierre’s syndrome: A forgotten and re-emerging infection. Journal of Microbiology, Immunology and Infection, 53, 513-517.

Noh, H. et al. (2015). Lemierre syndrome: a rare complication of pharyngotonsillitis. Braz J Otorhinolaryngol., 81(5), 568-570.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. Santa Maria/RS. Ed. UAB/NTE/UFSM.

Phua, C., Chadachan, V. & Acharya, R. (2013). Lemierre Syndrome - Should We Anticoagulate? A Case Report and Review of the Literature. Int J Angiol., 22, 137-142.

Pinho, L. E., Júnior, C. N. R. & da Silva, M. F. C. (2020). Síndrome de Lemierre em paciente com artrite idiopática juvenil de forma sistêmica em uso de tocilizumabe. Residência Pediátrica, 10(1), 41-43.

Rawes, C. et al. (2022). Abdominal variant Lemierre’s syndrome. Br J Hosp Med.

Taj, S. et al. (2022). Lemierre's Syndrome: A Comeback Story. Cureus, 14(6), e25843.

Tiwari, T. (2023). Lemierre’s Syndrome in the 21st Century: A Literature Review. Cureus, 15(8), e43685.

Toassi, R. F. C.; Petry, P. C. (2021). Metodologia científica aplicada à área da Saúde. 2ed. Editora da UFRGS.

Vijay, V. & Fattah, Z. (2018). Lesson of the month 1: Lemierre’s syndrome: a reminder of the ‘forgotten disease’. Clinical Medicine, 18(1), 100-2.

Published

23/12/2024

How to Cite

ANACHE, N. C. .; TOGNINI, A. L. L. de O. .; ROCHA, R. G. P. . Lemierre’s syndrome in a pediatric patient with otomastoiditis caused by Streptococcus anginosus: A case report. Research, Society and Development, [S. l.], v. 13, n. 12, p. e207131247915, 2024. DOI: 10.33448/rsd-v13i12.47915. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/47915. Acesso em: 5 jan. 2025.

Issue

Section

Health Sciences