Pediatr Gastroenterol Hepatol Nutr.  2018 Jul;21(3):214-217. 10.5223/pghn.2018.21.3.214.

Lemierre Syndrome in Adolescent with Active Ulcerative Colitis

• Unić J
• Kovačić
• Jakovljević G
• BatoÅ¡ AT
• Grmoja T
• Hojsak I

• KMID: 2415601
• DOI: http://doi.org/10.5223/pghn.2018.21.3.214

Abstract

Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

Keyword

Thrombosis; Thrombophlebitis; Inflammatory bowel diseases; Child

MeSH Terms

Adolescent*
Adult
Child
Colitis, Ulcerative*
Diagnosis
Female
Fever
Humans
Inflammatory Bowel Diseases
Jugular Veins
Lemierre Syndrome*
Neck Pain
Pharyngitis
Prognosis
Pulmonary Embolism
Risk Factors
Thrombophlebitis
Thrombosis
Ulcer*
Veins
Venous Thrombosis

Figure

• 

  Fig. 1 Neck magnetic resonance imaging at the time of admission. (A) Short tau inversion recovery, axial plane right jugular vein filing defect with soft tissue secondary edema extending to the right shoulder. (B) Contrast enhanced T1 vibe, axial plane filling defect in the right jugular vein.

• 

  Fig. 2 Neck color Doppler and ultrasound showing recanalization of the right jugular vein.

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