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Lemierres syndrom – En påminnelse om »den glömda sjukdomen« : God kunskap under hela vårdkedjan viktigt för att i tid väcka misstanke

Hedenmarkb, Jan; Holm, Karin LU ; Moberger, Fredrik and Torell, Erik (2018) In Lakartidningen 115(6). p.237-239
Abstract (Swedish)
Lemierres syndrom kännetecknas klassiskt av tonsillit, trombos i vena jugularis interna samt septiska lungembolier. Ofta har patienten också sepsis. Sjukdomen drabbar framför allt yngre personer i åldern 15–25 år.Effektiv antibiotikabehandling kopplad till kirurgisk lokal behandling (source control) över tid är fundamental i handläggningen.Sen diagnos och behandling ökar risken för komplicerat vårdförlopp.God kunskap om syndromets kliniska kännetecken i hela vårdkedjan, inte minst i primärvård, är viktig för att i tid väcka misstanken.Det är väsentligt att ha Lemierres syndrom i åtanke vid svår oklar tonsillit hos yngre vuxna.
Abstract

The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of medicine and an increased incidence of “the forgotten disease” may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality. People aged 15–25 years are commonly affected. Early diagnosis through positive blood culture and confirmation of jugular vein thrombosis combined with prompt antibiotic treatment and source control is mandatory in the... (More)

The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of medicine and an increased incidence of “the forgotten disease” may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality. People aged 15–25 years are commonly affected. Early diagnosis through positive blood culture and confirmation of jugular vein thrombosis combined with prompt antibiotic treatment and source control is mandatory in the management of Lemierre’s syndrome. Assessment of vital organ function is recommended across the continuum of care as this facilitates recognition and initiation of therapeutic measures to counteract a complicated clinical course.

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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Lakartidningen
volume
115
issue
6
pages
237 - 239
publisher
Swedish Medical Association
external identifiers
  • scopus:85041698362
ISSN
0023-7205
language
Swedish
LU publication?
no
id
16d3c048-7d73-42b4-b992-3f04220263bc
date added to LUP
2018-02-21 14:51:39
date last changed
2018-05-29 10:42:34
@article{16d3c048-7d73-42b4-b992-3f04220263bc,
  abstract     = {<p>The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of medicine and an increased incidence of “the forgotten disease” may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality. People aged 15–25 years are commonly affected. Early diagnosis through positive blood culture and confirmation of jugular vein thrombosis combined with prompt antibiotic treatment and source control is mandatory in the management of Lemierre’s syndrome. Assessment of vital organ function is recommended across the continuum of care as this facilitates recognition and initiation of therapeutic measures to counteract a complicated clinical course.</p>},
  author       = {Hedenmarkb, Jan and Holm, Karin and Moberger, Fredrik and Torell, Erik},
  issn         = {0023-7205},
  language     = {swe},
  month        = {02},
  number       = {6},
  pages        = {237--239},
  publisher    = {Swedish Medical Association},
  series       = {Lakartidningen},
  title        = {Lemierres syndrom – En påminnelse om »den glömda sjukdomen« : God kunskap under hela vårdkedjan viktigt för att i tid väcka misstanke},
  volume       = {115},
  year         = {2018},
}