Korean J Med.  2006 Apr;70(4):439-443.

A case of tricuspid valve infective endocarditis following Lemierre syndrome

Affiliations
  • 1Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea. mdssampak@yahoo.co.kr
  • 2Infection Control Unit, Pusan National University College of Medicine, Busan, Korea.
  • 3Department of Clinical Pathology, Pusan National University College of Medicine, Busan, Korea.
  • 4Department of Diagnostic Radiology, Pusan National University College of Medicine, Busan, Korea.

Abstract

Lemierre syndrome is characterized by an acute oropharyngeal infection with septic thrombophlebitis of the internal jugular vein, anaerobic bacteremia, and multiple metastatic abscess, frequently involving lung. The most common etiologic organism is Fusobacterium necrophorum. In this case, otomastoiditis causes internal jugular vein thrombophlebitis, which complicates pulmonary septic embolism and tricuspid valve endocarditis. The patient had no underlying heart disease and wasn't injection drug user. Blood culture revealed Bacteroides fragilis group and group G beta-hemolytic Streptococcus. Pulmonary septic embolism is common complication in patient with Lemierre syndrome, but endocarditis is very rare, moreover tricuspid valve involvement. As widespread use of antibiotics, this syndrome becomes rare and typical course of the disease has changed. It leads to decrease recognition of this syndrome. But, Lemierre syndrome is potentially fatal if early diagnosis and appropriate antibiotic treatment is not followed.

Keyword

Lemierre syndrome; Mastoiditis; Tricuspid valve endocarditis

MeSH Terms

Abscess
Anti-Bacterial Agents
Bacteremia
Bacteroides fragilis
Drug Users
Early Diagnosis
Embolism
Endocarditis*
Fusobacterium necrophorum
Heart Diseases
Humans
Jugular Veins
Lemierre Syndrome*
Lung
Mastoiditis
Streptococcus
Thrombophlebitis
Tricuspid Valve*
Anti-Bacterial Agents
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