Open AccessMRSA Bacteremia Associated with Lemierre Syndrome
Author(s) -
Kizhner Victor Zeev,
Samara Ghassan J.,
Panesar Rahul,
Krespi Yosef P.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a60
Subject(s) - medicine , bacteremia , clindamycin , sore throat , population , thrombophlebitis , pharyngitis , surgery , antibiotics , thrombosis , environmental health , microbiology and biotechnology , biology
Objective Community acquired MRSA (CA‐MRSA) is a growing health concern. CA‐MRSA behaves differently between the adult and pediatric population. Lemierre’s syndrome is septic jugular thrombophlebitis affecting mainly young adults. We intend to identify a possible sub group of Lemierre’s syndrome (LS) associated with CA‐MRSA through a case report and literature review. Method We review a case report of an 18‐year‐old athlete admitted for increasing fever, tachycardia, tachypnea, and neck pain. MRSA bacteremia was identified, and following ARDS the patient was intubated. Neck CT showed jugular thrombophlebitis at the skull base. The patient was treated with rifampin, vancomycin, ceftriaxone, and clindamycin. Results Following intravenous antibiotic treatment the patient improved and was extubated, and subsequent CT and Doppler showed normal jugular flow. Sterilization of blood cultures predicted improvement. A literature review showed a rise in the past 2 years of LS associated with MRSA all with patients less than 18 years old. Conclusion CA‐MRSA in the pediatric population is associated with dermatologic infection and trauma. CA‐MRSA bacteremia can lead to pulmonary sequela. CA‐MRSA associated with pharyngitis, nasopharyngitis, and parapharyngeal lymphadenitis may predispose one to LS. LS can be associated with CA‐MRSA. As the CA‐MRSA carrier is predominantly nasal, pharyngitis may not be present.