Lemierre Syndrome: Clinical Update and Protocol for a Systematic Review and Individual Patient Data Meta-analysis.

Sacco, Clara; Zane, Federica; Granziera, Serena; Holm, Karin; Creemers-Schild, Dina; Hotz, Michael-André; Turpini, Elena; Valentini, Adele; Righini, Christian; Karkos, Petros D; Verhamme, Peter; Di Nisio, Marcello; Konstantinides, Stavros; Pecci, Alessandro; Barco, Stefano (2019). Lemierre Syndrome: Clinical Update and Protocol for a Systematic Review and Individual Patient Data Meta-analysis. Hämostaseologie, 39(1), pp. 76-86. Thieme 10.1055/s-0038-1654720

[img] Text
s-0038-1654720.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (347kB) | Request a copy

Lemierre syndrome usually affects otherwise healthy adolescents or young adults and occurs at an overall rate of 1 to 10 cases per million person-years with an estimated fatality rate of 4 to 9%. Diagnostic criteria remain debated and include acute neck/head bacterial infection (often tonsillitis caused by anaerobes at high potential for sepsis and vascular invasion, notably Fusobacterium necrophorum) complicated by local vein thrombosis, usually involving the internal jugular vein, and systemic septic embolism. Medical treatment is based on antibiotic therapy with anaerobic coverage, anticoagulant drugs and supportive care in case of sepsis. Surgical procedures can be required, including drainage of the abscesses, tissue debridement and jugular vein ligation. Evidence for clinical management is extremely poor in the absence of any adequately sized study with clinical outcomes. In this article, we illustrate two cases of Lemierre syndrome not caused by Fusobacterium necrophorum and provide a clinically oriented discussion on the main issues on epidemiology, pathophysiology and management strategies of this disorder. Finally, we summarize the study protocol of a proposed systematic review and individual patient data meta-analysis of the literature. Our ongoing work aims to investigate the risk of new thromboembolic events, major bleeding or death in patients diagnosed with Lemierre syndrome, and to better elucidate the role of anticoagulant therapy in this setting. This effort represents the starting point for an evidence-based treatment of Lemierre syndrome built on multinational interdisciplinary collaborative studies.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Hotz, Michael André

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0720-9355

Publisher:

Thieme

Language:

English

Submitter:

Stefan Weder

Date Deposited:

22 Jan 2020 12:00

Last Modified:

30 Mar 2020 15:54

Publisher DOI:

10.1055/s-0038-1654720

PubMed ID:

30071559

BORIS DOI:

10.7892/boris.137955

URI:

https://boris.unibe.ch/id/eprint/137955

Actions (login required)

Edit item Edit item
Provide Feedback