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Patients with Lemie...
Patients with Lemierre syndrome have a high risk of new thromboembolic complications, clinical sequelae and death : an analysis of 712 cases
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- Valerio, Luca (author)
- Universitätsmedizin Mainz
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- Zane, Federica (author)
- Hospital of Sondrio
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- Sacco, Clara (author)
- Humanitas Research Hospital
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Granziera, Serena (author)
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- Nicoletti, Tommaso (author)
- Policlinico Universitario Agostino Gemelli
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- Russo, Mariaconcetta (author)
- Universitätsmedizin Mainz
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- Corsi, Gabriele (author)
- Fatebenefratelli Hospital
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- Holm, Karin (author)
- Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Translationell infektionsmedicin,Forskargrupper vid Lunds universitet,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Translational infection medicine,Lund University Research Groups
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- Hotz, Michel André (author)
- University of Bern
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- Righini, Christian (author)
- Grenoble University Hospital
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- Karkos, Petros D. (author)
- Aristotle University of Thessaloniki
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- Mahmoudpour, Seyed Hamidreza (author)
- Universitätsmedizin Mainz
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- Kucher, Nils (author)
- University Hospital of Zurich
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- Verhamme, Peter (author)
- University Hospitals Leuven
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- Di Nisio, Marcello (author)
- University G.d'Annunzio of Chieti-Pescara
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Centor, Robert M. (author)
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- Konstantinides, Stavros V. (author)
- Universitätsmedizin Mainz,Democritus University of Thrace
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- Pecci, Alessandro (author)
- Policlinico San Matteo Pavia Fondazione
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- Barco, Stefano (author)
- University Hospital of Zurich,Universitätsmedizin Mainz
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(creator_code:org_t)
- 2020-06-18
- 2021
- English.
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In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 289:3, s. 325-339
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- anticoagulation
- Fusobacterium necrophorum
- Lemierre syndrome
- pulmonary embolism
- septic embolism
- venous thromboembolism
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Valerio, Luca
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Zane, Federica
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Sacco, Clara
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Granziera, Seren ...
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Nicoletti, Tomma ...
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Russo, Mariaconc ...
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show more...
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Corsi, Gabriele
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Holm, Karin
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Hotz, Michel And ...
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Righini, Christi ...
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Karkos, Petros D ...
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Mahmoudpour, Sey ...
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Kucher, Nils
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Verhamme, Peter
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Di Nisio, Marcel ...
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Centor, Robert M ...
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Konstantinides, ...
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Pecci, Alessandr ...
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Barco, Stefano
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- MEDICAL AND HEALTH SCIENCES
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Lund University