Lemierre’s syndrome in a child. Literature review and own observations

Abstract

Lemierre syndrome is extremely rare and poorly known to medical practitioners. In  childhood, this is completely casuistry, described almost exclusively in adolescents. The  key component of the syndrome is jugular vein thrombosis and sinus thrombosis, which develop against the background of polysinusitis and  purulent  otitis  and  are also  accompanied by  the  addition  of  pneumonia, meningitis  and  sepsis. Typically,  Lemierre’s syndrome is considered otogenic or sinusogenic sepsis. The nonspecificity of clinical manifestations against the background of the patient’s severe general condition determines the need for quick and accurate diagnosis, and ultrasound takes the first place in a series of radiation research methods, which allows differentiating jugular vein thrombosis. When the latter is found, MRI and CT are usually performed, in which  the presence of sinus thrombosis, inflammatory changes in the paranasal sinuses, pneumonia, etc. are usually confirmed. Further clinical and laboratory examination is designed to assess the presence of meningitis and a violation of the blood coagulation system. This publication provides 3 atypical observations of Lemierre’s syndrome in children: in the first case, it was thrombosis of the jugular vein that was first detected in an adolescent, and only then all other components of the syndrome; in the second case, the child was only 3 years old, which is completely atypical for this pathology, the third patient was 1 month old, and the diagnosis of Lemierre syndrome was made retrospectively. All children underwent a complex radiation examination, operated on, received massive syndrome therapy and were discharged home with recovery. The publication is extensively illustrated and contains a brief overview of the literature.