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    Clival osteomyelitis and hypoglossal nerve palsy-rare complications of Lemierre's syndrome

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    URI
    http://hdl.handle.net/11287/593986
    Author
    He, J.
    Lam, J. C.
    Adlan, Tarig
    Date
    2015-08-30
    Journal
    BMJ case reports
    Type
    Case Report
    Publisher
    BMJ
    DOI
    10.1136/bcr-2015-209777
    Metadata
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    Abstract
    An increasingly reported entity, Lemierre's syndrome classically presents with a recent oropharyngeal infection, internal jugular vein thrombosis and the presence of anaerobic organisms such as Fusobacterium necrophorum. The authors report a normally fit and well 17-year-old boy who presented with severe sepsis following a 5-day history of a sore throat, myalgia and neck stiffness requiring intensive care admission. Blood cultures grew F. necrophorum and radiological investigations demonstrated left internal jugular vein, cavernous sinus and sigmoid sinus thrombus, left vertebral artery dissection and thrombus within the left internal carotid artery. Imaging also revealed two areas of acute ischaemia in the brain, consistent with septic emboli, skull base (clival) osteomyelitis and an extensive epidural abscess. The patient improved on meropenem and metronidazole and was warfarinised for his cavernous sinus thrombosis. He has an on-going left-sided hypoglossal (XIIth) nerve palsy.
    Citation
    BMJ Case Rep. 2015 Aug 30;2015
    Publisher URL
    http://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=26323975
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