Lemierre Syndrome Secondary to Community-acquired Methicillin-resistant Staphylococcus Aureus Infection Associated with Cavernous Sinus Thromboses

Abstract

BackgroundLemierre Syndrome (LS) is a highly aggressive rare disease process with a predilection for young, healthy adolescents. Often beginning with a primary cervicofacial infection, LS rapidly progresses to thrombophlebitis of the cerebral vasculature, metastatic infection, and septicemia. Untreated LS can be rapidly fatal. Thrombus within the cerebral vasculature can have devastating neurological effects. Advances in antibacterial therapy have resulted in a global decline in the incidence of LS, and clinicians may not consider LS early in the disease process. Although the mortality of LS has declined, the morbidity associated with the disease has increased, particularly the neurological sequelae. ObjectivesThis report will provide readers with a better understanding of the etiology, clinical presentation, evaluation methods, and appropriate treatment of LS. Case ReportWe present an atypical case of LS secondary to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection progressing to bilateral cavernous sinus and ophthalmic vein thromboses with resultant binocular vision loss secondary to optic nerve and retinal ischemia. ConclusionThis case highlights the importance of early recognition of LS in the setting of a community-acquired MRSA infection as the unifying condition in a young patient with multiple acute neurologic impairments.