Ophthalmic complications of Lemierre syndrome
| Autor: | Karin Holm, Christian Righini, Gabriele Corsi, Luca Valerio, Sandrine Zweifel, Clara Sacco, Federica Zane, Robert Kreuzpointner, Alessandro Pecci, Stefano Barco |
|---|---|
| Přispěvatelé: | University of Zurich, Valerio, Luca |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 10018 Ophthalmology Clinic medicine.medical_specialty Adolescent Nerve Paralysis 610 Medizin 610 Medicine & health Blindness Young Adult 03 medical and health sciences 0302 clinical medicine 610 Medical sciences medicine Humans Lemierre Syndrome Child Aged Paresis Septic embolism Venous Thrombosis biology business.industry Incidence 10031 Clinic for Angiology General Medicine Middle Aged Mycotic aneurysm 2731 Ophthalmology biology.organism_classification medicine.disease Surgery Europe Decreased vision Ophthalmology Stenosis Fusobacterium Child Preschool 030221 ophthalmology & optometry Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Acta Ophthalmologica. 100 |
| ISSN: | 1755-3768 1755-375X |
| Popis: | PURPOSE Lemierre syndrome is a life-threatening condition characterized by head/neck bacterial infection, local suppurative thrombophlebitis and septic embolic complications in a range of sites of distant organs. No prior study focused on the course and characteristics of ophthalmic complications of Lemierre syndrome. METHODS We analysed data of 27 patients with ophthalmic complications from a large cohort of 712 cases with Lemierre syndrome reported globally between 2000 and 2017. We focused on initial manifestations, early (in-hospital) course and long-term ophthalmic deficits at the time of hospital discharge or during postdischarge follow-up. The study protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (CRD42016052572). RESULTS Nine (33%) patients were women; the median age was 20 (Q1-Q3: 15-33) years. Fusobacterium spp. was involved in 56% of cases. The most prevalent initial manifestations were decreased vision (35%) and periocular oedema (38%), followed by impaired eye movements/nerve palsy (28%) and proptosis (28%). Venous involvement, notably cerebral vein thrombosis (70%) and ophthalmic vein thrombosis (55%), explained the symptomatology in most cases. Septic embolism (7%), orbital abscesses (2%) and carotid stenosis (14%) were also present. Ophthalmic sequelae were reported in 9 (33%) patients, often consisting of blindness or reduced visual acuity, and nerve paralysis/paresis. CONCLUSION Ophthalmic complications represent a severe manifestation of Lemierre syndrome, often reflecting an underlying cerebral vein thrombosis. Visual acuity loss and long-term severe complications are frequent. We call for an interdisciplinary approach to the management of patients with Lemierre syndrome and the routine involvement of ophthalmologists. |
| Databáze: | OpenAIRE |
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