Ophthalmic complications of Lemierre syndrome
(2022) In Acta Ophthalmologica 100(1).- Abstract
Purpose: Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. Methods: We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic... (More)
Purpose: Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. Methods: We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (CRD42016052572). Results: Nine (33%) patients were women; the median age was 20 (Q1–Q3: 15–33) years. Fusobacterium spp. was involved in 56% of cases. The most prevalent initial manifestations were decreased vision (35%) and periocular oedema (38%), followed by impaired eye movements/nerve palsy (28%) and proptosis (28%). Venous involvement, notably cerebral vein thrombosis (70%) and ophthalmic vein thrombosis (55%), explained the symptomatology in most cases. Septic embolism (7%), orbital abscesses (2%) and carotid stenosis (14%) were also present. Ophthalmic sequelae were reported in 9 (33%) patients, often consisting of blindness or reduced visual acuity, and nerve paralysis/paresis. Conclusion: Ophthalmic complications represent a severe manifestation of Lemierre syndrome, often reflecting an underlying cerebral vein thrombosis. Visual acuity loss and long-term severe complications are frequent. We call for an interdisciplinary approach to the management of patients with Lemierre syndrome and the routine involvement of ophthalmologists.
(Less)
- author
- Kreuzpointner, Robert ; Valerio, Luca ; Corsi, Gabriele ; Zane, Federica ; Sacco, Clara ; Holm, Karin LU ; Righini, Christian ; Pecci, Alessandro ; Zweifel, Sandrine and Barco, Stefano
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- anticoagulation, bacterial infection, lemierre syndrome, mycotic aneurysm, ocular vein thrombosis, rare disorders
- in
- Acta Ophthalmologica
- volume
- 100
- issue
- 1
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85104006084
- pmid:33829646
- ISSN
- 1755-375X
- DOI
- 10.1111/aos.14871
- language
- English
- LU publication?
- yes
- id
- 311eab62-08e3-43e0-82c1-27e1cff0151c
- date added to LUP
- 2021-04-23 06:50:19
- date last changed
- 2024-09-21 19:18:59
@article{311eab62-08e3-43e0-82c1-27e1cff0151c, abstract = {{<p>Purpose: Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. Methods: We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (CRD42016052572). Results: Nine (33%) patients were women; the median age was 20 (Q1–Q3: 15–33) years. Fusobacterium spp. was involved in 56% of cases. The most prevalent initial manifestations were decreased vision (35%) and periocular oedema (38%), followed by impaired eye movements/nerve palsy (28%) and proptosis (28%). Venous involvement, notably cerebral vein thrombosis (70%) and ophthalmic vein thrombosis (55%), explained the symptomatology in most cases. Septic embolism (7%), orbital abscesses (2%) and carotid stenosis (14%) were also present. Ophthalmic sequelae were reported in 9 (33%) patients, often consisting of blindness or reduced visual acuity, and nerve paralysis/paresis. Conclusion: Ophthalmic complications represent a severe manifestation of Lemierre syndrome, often reflecting an underlying cerebral vein thrombosis. Visual acuity loss and long-term severe complications are frequent. We call for an interdisciplinary approach to the management of patients with Lemierre syndrome and the routine involvement of ophthalmologists.</p>}}, author = {{Kreuzpointner, Robert and Valerio, Luca and Corsi, Gabriele and Zane, Federica and Sacco, Clara and Holm, Karin and Righini, Christian and Pecci, Alessandro and Zweifel, Sandrine and Barco, Stefano}}, issn = {{1755-375X}}, keywords = {{anticoagulation; bacterial infection; lemierre syndrome; mycotic aneurysm; ocular vein thrombosis; rare disorders}}, language = {{eng}}, number = {{1}}, publisher = {{Wiley-Blackwell}}, series = {{Acta Ophthalmologica}}, title = {{Ophthalmic complications of Lemierre syndrome}}, url = {{http://dx.doi.org/10.1111/aos.14871}}, doi = {{10.1111/aos.14871}}, volume = {{100}}, year = {{2022}}, }