Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of Lemierre syndrome associated with infectious cavernous sinus thrombosis and septic meningitis

Kouhei Shibuya, M.D.1), Shuichi Igarashi, M.D. Ph.D.1), Tomoe Sato, M.D.1), Junsuke Shinbo, M.D.1), Aki Sato, M.D. Ph.D.1) and Motoyoshi Yamazaki, M.D.1)2)

1)Department of Neurology, Niigata City General Hospital
2)Department of Neurology, Toukamachi Hospital, Niigata Prefectural Hospital

A 33-year-old man was admitted to our hospital because of right exophthalmos, diplopia and left neck pain. Neurological examination revealed lateral and inferior disturbance of his right eye movement and the meningeal irritation sign. Cerebrospinal fluid showed elevated polynuclear cells. Enhanced CT and MRI revealed thrombophlebitis of the left internal jugular vein and bilateral cavernous sinuses. On the basis of these findings, he was diagnosed as having Lemierre syndrome associated with cavernous sinus thrombophlebitis and bacterial meningitis. After administration of antibiotics, his symptoms disappeared and the data of laboratory analyses also improved. However, after his discharge, he was required re-antibiotics therapy because of septic embolus- induced multiple lung abscesses. Lemierre syndrome is characterized by disseminated abscesses and thrombophlebitis of the internal jugular vein after infection of the oropharynx. Because Lemierre syndrome is potentially lifethreatening, early diagnosis and initiation of appropriate therapy are important.
Full Text of this Article in Japanese PDF (494K)

(CLINICA NEUROL, 52: 782|785, 2012)
key words: Lemierre syndrome, infectious cavernous sinus thrombosis, septic meningitis, exophthalmos, thrombophlebitis of the left internal jugular vein

(Received: 2-Apr-12)