Lemierre syndrome in a 5-month-old male infant: Case report and review of the pediatric literature

Pediatr Crit Care Med. 2008 Sep;9(5):e35-7. doi: 10.1097/PCC.0b013e31817319fa.

Abstract

Objectives: To report, to the best of our knowledge, the youngest patient with Lemierre syndrome.

Design: Descriptive case report with review of the pediatric literature.

Setting: Pediatric intensive care unit in a tertiary referral hospital.

Data source: Systemic review of the literature, including PubMed (English-only journals) and major textbooks.

Patient: We report a 5-month-old boy who presented with fever and a perforated left-sided otitis media. He developed left-sided complicated otitis media with retroauricular fluid collection, mastoiditis, and temporomandibular joint effusion. The clinical picture was complicated by a left internal jugular vein and left lateral sinus thrombosis. Fusobacterium necrophorum grew in the pus culture.

Interventions: Low molecular weight heparin.

Measurements and main results: No immunodeficiency and no thrombophilia were identified as predisposing conditions for Lemierre syndrome. Surgical drainage, early and adequate antibiotic treatment, and anticoagulation were followed by complete recovery.

Conclusions: This case report illustrates that Lemierre syndrome can occur in infants without underlying risk factors for severe infections or thrombotic complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Fever / etiology
  • Fusobacterium / isolation & purification*
  • Fusobacterium Infections / complications
  • Fusobacterium Infections / diagnostic imaging*
  • Fusobacterium Infections / pathology
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Infant
  • Jugular Veins / diagnostic imaging
  • Jugular Veins / pathology
  • Magnetic Resonance Imaging
  • Male
  • Otitis Media / complications*
  • Sepsis / etiology
  • Syndrome
  • Thrombophlebitis / drug therapy
  • Thrombophlebitis / etiology*
  • Tomography, X-Ray Computed

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight