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Pediatría Atención Primaria

Print version ISSN 1139-7632

Abstract

MARIN ANDRES, Marta; GUTIERREZ SANCHEZ, Aída Mª; GUERRERO LALEONA, Carmelo  and  BUSTILLO ALONSO, Matilde. Acute otitis media: a rare cause of Lemierre's syndrome. Rev Pediatr Aten Primaria [online]. 2019, vol.21, n.83, pp.e145-e149.  Epub Dec 09, 2019. ISSN 1139-7632.

Lemierre's syndrome is a rare and potentially lethal disease that originates as a complication of a localized infection at the head and neck level that extends to the carotid space. It is associated with septic thrombophlebitis of the internal jugular vein and often produces septic emboli at a distance. It usually presents as a picture of fever and odynophagia several days after the history of an apparently resolved oropharyngeal infection. Other less frequent infectious foci may correspond to mastoiditis, sinusitis or acute otitis media. The diagnosis is fundamentally clinical and supported by imaging tests such as Doppler ultrasound and cervical CT with contrast. The treatment consists of prolonged antibiotic therapy with adequate coverage for anaerobes, especially Fusobacterium necrophorum, which is the most frequent pathogen. The role of anticoagulation in Lemierre's syndrome is controversial. We present a case of Lemierre's syndrome secondary to acute otitis media.

Keywords : Embolism; Otitis media; Lemierre syndrome; Septic thrombophlebitis; Jugular vein.

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