Lemierre's Syndrome and Nasopharyngitis in Children: DIAGNOSIS and Treatment-Reference-Cited by-同舟云学术

Lemierre's Syndrome and Nasopharyngitis in Children: DIAGNOSIS and Treatment

Published:2024-04-17 Issue:1 Volume:10 Page:23-27
ISSN:2472-2413
Container-title:International Journal of Otorhinolaryngology
language:en
Short-container-title:IJO

Author:

Djibril Samaké¹,Youssouf Sidibé²,Maimouna Kanté³,Ya Traoré³,Oumar Kéita⁴,Ghislaine Ngniée⁵,El-Mehdi El⁶,Issa Koné⁷,Karim Timbo⁷,Amadou Kéïta⁷

Affiliation:

1. ENT Unit, Reference Health Center of Commune V of the Bamako District, Bamako, Mali

2. ENT and Head and Neck Surgery Department, CHU Mother-Child “Luxembourg”, Bamako, Mali

3. Pediatric Unit, Reference Health Center of Commune V of the Bamako District, Bamako, Mali

4. Medical Imaging Department, Mohamed VI Perinatal Clinic, Bamako, Mali

5. ENT Unit, Reference Health Center of Commune I of the Bamako District, Bamako, Mali

6. ENT Unit, Reference Health Center of Commune VI of the Bamako District, Bamako, Mali

7. ENT Department, Gabriel Touré University Hospital, Bamako, Mali

Abstract

Introduction: Lemierre’s syndrome (LS) is a rare but serious infectious emergency. It can be life threatening. It is a sepsis difficult to recognize and most often due to Fusobacterium necrophorum. The purpose of this case report was to discuss the diagnosis and treatment of Lemierre syndrome in children. Observation: A three-year-old child consulted for rhinopharyngitis complicated by an abscessed cervical adenophlegmon. The symptomatology had been evolving for 7 days with a notion of self-medication. The blood cell count showed hyperleukocytosis at 14.06.103 elements/mm3, anemia at 8.2.106 elements/mm3, and platelets at 102.103 elements/mm3. CRP was 258.5 mg/dL. HIV serology was negative. Bacteriological culture of the biological fluids collected (abscess pus, blood and joint fluid) was sterile. The CT scan revealed a collection of abscesses in the right sub-angulo-mandibular region. It was associated with thrombophlebitis of the internal jugular vein, as well as pulmonary and joint infections. The diagnosis of Lemierre syndrome was done. Cervicotomy allowed drainage of the abscess. A triple parenteral antibiotic therapy (Ceftriaxone, Metronidazole, Gentamycin) with per-os relay by Amoxicillin + Clavulanic Acid allowed to obtain the cure in one month of treatement without complications. Conclusion: LS is difficult to diagnose due to its non-specific clinical presentation and low incidence. Early clinical and imaging diagnosis guarantees a good outcome by allowing adequate treatment.

Publisher

Science Publishing Group

Link

https://article.sciencepublishinggroup.com/pdf/j.ijo.20241001.15

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