Autoren:	Valerio, Luca Zane, F. Sacco, C. Granziera, S. Nicoletti, T. Russo, M. Corsi, G Holm, K. Hotz, M.-A. Righini, C. Karkos, P. D. Mahmoudpour, Seyed Hamidreza Kucher, N. Verhamme, P. Di Nisio, M. Centor, M. Konstantinides, Stavros V. Pecci, A. Barco, Stefano
Titel:	Patients with Lemierre syndrome have a high risk of new thromboembolic complications, clinical sequelae and death : an analysis of 712 cases
Online-Publikationsdatum:	2-Aug-2021
Erscheinungsdatum:	2021
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	BACKGROUND Lemierre syndrome is characterized by head/neck vein thrombosis and septic embolism usually complicating an acute oropharyngeal bacterial infection in adolescents and young adults. We described the course of Lemierre syndrome in the contemporary era. METHODS In our individual-level analysis of 712 patients (2000–2017), we included cases described as Lemierre syndrome if these criteria were met: (i) primary site of bacterial infection in the head/neck; (ii) objectively confirmed local thrombotic complications or septic embolism. The study outcomes were new or recurrent venous thromboembolism or peripheral septic lesions, major bleeding, all-cause death and clinical sequelae. RESULTS The median age was 21 (Q1–Q3: 17–33) years, and 295 (41%) were female. At diagnosis, acute thrombosis of head/neck veins was detected in 597 (84%) patients, septic embolism in 582 (82%) and both in 468 (80%). After diagnosis and during in-hospital follow-up, new venous thromboembolism occurred in 34 (5.2%, 95% CI 3.8–7.2%) patients, new peripheral septic lesions became evident in 76 (11.7%; 9.4–14.3%). The rate of either was lower in patients who received anticoagulation (OR: 0.59; 0.36–0.94), higher in those with initial intracranial involvement (OR: 2.35; 1.45–3.80). Major bleeding occurred in 19 patients (2.9%; 1.9–4.5%), and 26 died (4.0%; 2.7–5.8%). Clinical sequelae were reported in 65 (10.4%, 8.2–13.0%) individuals, often consisting of cranial nerve palsy (n = 24) and orthopaedic limitations (n = 19). CONCLUSIONS Patients with Lemierre syndrome were characterized by a substantial risk of new thromboembolic complications and death. This risk was higher in the presence of initial intracranial involvement. One-tenth of survivors suffered major clinical sequelae.
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-6227
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY-NC
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by-nc/4.0/
Zeitschrift:	Journal of internal medicine 289 3
Seitenzahl oder Artikelnummer:	325 339
Verlag:	Wiley-Blackwel
Verlagsort:	Oxford u.a.
Erscheinungsdatum:	2021
ISSN:	1365-2796
URL der Originalveröffentlichung:	https://doi.org/10.1111/joim.13114
DOI der Originalveröffentlichung:	10.1111/joim.13114
Enthalten in den Sammlungen:	JGU-Publikationen