Ophthalmic complications of Lemierre syndrome

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title = "Ophthalmic complications of Lemierre syndrome",
abstract = "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.",
keywords = "anticoagulation, bacterial infection, lemierre syndrome, mycotic aneurysm, ocular vein thrombosis, rare disorders",
author = "Robert Kreuzpointner and Luca Valerio and Gabriele Corsi and Federica Zane and Clara Sacco and Karin Holm and Christian Righini and Alessandro Pecci and Sandrine Zweifel and Stefano Barco",
year = "2021",
doi = "10.1111/aos.14871",
language = "English",
journal = "Acta Ophthalmologica",
issn = "1755-3768",
publisher = "Wiley-Blackwell",