Gastrointestinal variant of Lemierre's syndrome complicating ruptured appendicitis. Issue 3 (2015)

• Record Type: Journal Article
• Authors: Akhrass, Fadi Al; Abdallah, Lina; Berger, Steven; Sartawi, Rami
• Is Part Of: IDCases. Volume 2:Issue 3(2015)
• Page Start: 72
• Page End: 76
• Publication Date: 2015
• Subjects: Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2015.07.001
• Languages: English
• ISSNs: 2214-2509

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <p id="spar0005"> <italic>Fusobacterium necrophorum</italic> is a non-spore-forming, obligate anaerobic, filamentous, gramnegative bacillus that frequently colonizes the human oral cavity, respiratory tract, and gastrointestinal tract. <italic>Fusobacterium</italic> species have rarely been implicated in cases of gastrointestinal variant of Lemierre's syndrome. We describe a case of <italic>F. necrophorum</italic> bacteremia associated with suppurative porto-mesenteric vein thrombosis (PVT) following acute ruptured appendicitis. In addition, we list the documented twelve cases of <italic>Fusobacterium</italic> pylephlebitis. Recanalization of the porto-mesenteric veins and relief of the extrahepatic portal hypertension were achieved with early empiric antibiotic and local thrombolytic therapy. Our patient's case underscores the importance of recognizing <italic>Fusobacterium</italic> bacteremia as a possible cause of suppurative PVT after disruption of the gastrointestinal mucosa following an acute intraabdominal infectious process. Early treatment of this condition using anticoagulation and endovascular thrombolysis as adjunctive therapies may prevent PVT complications.</p> </sec> </abstract>