Document Detail


Infection by Panton-Valentine leukocidin-producing Staphylococcus aureus clinically mimicking Lemierre's syndrome.
MedLine Citation:
PMID:  18065677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lemierre's syndrome is an oropharyngeal infection which leads to severe septic thrombophlebitis of the internal jugular vein and metastatic abscesses of the lungs and other organs. It is usually caused by Fusobacterium necrophorum, a Gram-negative obligate anaerobe. An unusual case of Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus infection masquerading as Lemierre's syndrome is reported here. A 32-year-old fit and otherwise healthy male presented on Christmas morning with a boil on his left cheek for 2 days and generalized rash for 3 h. His general condition began to worsen, he developed facial swelling and loss of vision in the left eye and was transferred to the intensive care unit. His treatment was taken over by team of specialists and further investigations revealed thrombophlebitis of the left internal jugular vein and cavernous sinus thrombosis with multiple brain infarcts and lung abscesses. His condition remained critical with multiple cranial nerve involvement despite being on broad-spectrum antibiotics. Blood cultures grew S. aureus which was producing PVL toxin. He improved gradually over several weeks. He underwent intensive physiotherapy and made a good recovery. Although a rare entity, it is important to consider Lemierre's syndrome in septic patients who present with rapidly worsening symptoms.
Authors:
Girish H Shivashankar; Nishanth Murukesh; M P S Varma; Ikram M Sharif; Gerard Glynn
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of medical microbiology     Volume:  57     ISSN:  0022-2615     ISO Abbreviation:  J. Med. Microbiol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-10     Completed Date:  2008-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0224131     Medline TA:  J Med Microbiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  118-20     Citation Subset:  IM    
Affiliation:
Erne Hospital, Enniskillen, Fermanagh BT74 6AY, UK. girishshivashankar@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Bacteremia / diagnosis,  microbiology
Bacterial Toxins / toxicity*
Exotoxins / toxicity*
Humans
Jugular Veins
Leukocidins / toxicity*
Male
Staphylococcal Infections / microbiology,  physiopathology*
Staphylococcus aureus / chemistry,  genetics,  pathogenicity*
Syndrome
Thrombosis / etiology
Chemical
Reg. No./Substance:
0/Bacterial Toxins; 0/Exotoxins; 0/Leukocidins; 0/Panton-Valentine leukocidin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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