Severe atypical Lemierre syndrome caused by methicillin-sensitive Staphylococcus aureus: Two pediatric case reports

Arch Pediatr. 2023 Jul;30(5):343-346. doi: 10.1016/j.arcped.2023.02.007. Epub 2023 Mar 27.

Abstract

Background: Lemierre syndrome is typically associated with ear, nose, and throat (ENT) infections caused by Fusobacterium necrophorum. Since 2002, cases of atypical Lemierre-like syndrome secondary to Staphylococcus aureus have been reported.

Cases: We report two pediatric cases of atypical Lemierre syndrome with a similar presentation: exophthalmia, absence of pharyngitis, metastatic lung infection, and intracranial venous sinus thrombosis. Both patients had a favorable outcome following treatment with antibiotics, anticoagulation, and corticosteroids.

Conclusion: Regular therapeutic monitoring of antibiotic levels helped to optimize antimicrobial treatment in both cases.

Keywords: Lemierre syndrome; Pediatric intensive care; Staphylococcus aureus; Therapeutic drug monitoring.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Humans
  • Lemierre Syndrome* / complications
  • Lemierre Syndrome* / diagnosis
  • Lemierre Syndrome* / drug therapy
  • Methicillin / therapeutic use
  • Pharyngitis* / etiology
  • Staphylococcal Infections* / complications
  • Staphylococcal Infections* / diagnosis
  • Staphylococcal Infections* / drug therapy
  • Staphylococcus aureus

Substances

  • Methicillin
  • Anti-Bacterial Agents