Lemirre Syndrome

LEMIERRE SYNDROME “POST ANGINAL SEPTICEMIA”
A. LEMIERRE—-1936
PRIMARILY A Dz OF ADOLESCENTS AND YOUNG ADULTS
A FUSOBACTERIUM NECROPHORUM (NECROBACILLUS) ACUTE PHARYNGOTONSILLITIS
MAY GIVE A FALSE + MONO SPOT—-CAN DELAY THE DIAGNOSIS
SYNDROME: ACUTE PHARYNGOTONSILLITIS, HYPERPYREXIA WITH INITIAL RIGOR, NECK PAIN AND SWELLING(OFTEN TORTICOLLIC APPEARANCE), IJV THROMBOSIS (CAN INFECT AND THROMBOSE THE IJV BY EITHER DIRECT EXTENSION OR BY HEMATOGENOUS SPREAD) AND POSSIBLE PICKET FENCE TEMPERATURE CURVE OF SEPTIC EMBOLI—PRIMARILY TO THE LUNG AND JOINTS (ARTHRALGIAS)—ESPECIALLY THE HIPS
HIGH LFT’S
+TOBEY AYER -QUICKENSTAT TEST
Dx: THROAT CULTURE (ANAEROBIC) DUPLEX OF IJV
Rx: IV FLAGYL, IMIPENUM, OR CLEOCIN –HAS SOME ANTI-EXOTOXIN EFFECTS+/- ANTICOAGULATION +/- IJV LIGATION

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