Severe atypical Lemierre syndrome caused by methicillin-sensitive Staphylococcus aureus: Two pediatric case reports - 28/03/23

Doi : 10.1016/j.arcped.2023.02.007

R. El Hajj ^a, A. Stanzelova ^b,^c, C. de Marcellus ^d, M. Kossorotoff ^e, F. Remangeon ^c,^f, C.-J. Roux ^g, R. Touzé ^h,^c, J. Toubiana ^b,^c, S. Benaboud ⁱ, M. Oualha ^c,^d, F. Moulin ^d, C. Collignon ^d,^⁎
^a Pediatrics, André Mignot Hospital, Versailles, France
^b Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Paris, France
^c Université de Paris Cité, Paris, France
^d Pediatric Intensive Care Unit, APHP University Hospital Necker-Enfants Malades, Paris, France
^e Pediatric Neurology, APHP University Hospital Necker-Enfants Malades, Paris, France
^f Pediatric Otorhinolaryngology Department, APHP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
^g Pediatric Radiology, APHP University Hospital Necker-Enfants Malades, Paris, France
^h Ophthalmology Department and Reference Center for Rare Ophthalmological Diseases (OPHTARA), AP-HP, University Hospital Necker-Enfants Malades, Paris, France
ⁱ Pharmacology Department, Cochin Hospital, AP-HP Centre-Université de Paris, Paris, France

^⁎Corresponding author at: Pediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, 149 rue de Sèvres, 75015 Paris, France.Pediatric Intensive Care UnitNecker-Enfants Malades University Hospital149 rue de SèvresParis75015France

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Abstract

Background

Lemierre syndrome is typically associated with ear, nose, and throat (ENT) infections caused by Fusobacterium necrophorum. Since 2002, cases of atypical Lemierre-like syndrome secondary to Staphylococcus aureus have been reported.

Cases

We report two pediatric cases of atypical Lemierre syndrome with a similar presentation: exophthalmia, absence of pharyngitis, metastatic lung infection, and intracranial venous sinus thrombosis. Both patients had a favorable outcome following treatment with antibiotics, anticoagulation, and corticosteroids.