A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation
Authors: Matteo Doneddu, Francesco Marongiu
Introduction: We describe here a case of a woman admitted to our Internal Medicine Unit for multifocal pneumonia. During the stay, she presented a few neurological symptoms: headache, nausea, emesis, photophobia, and gait disturbance. Methodology: Chest computed tomography (CT) detected multiple areas interpreted as septic emboli. Moreover, a left internal jugular thrombosis (LIJT) was incidentally reported. A CT-angiography showed the LIJT extension to cerebral sinuses. Ear, nose, and throat consultation revealed a left medium otitis. Anticoagulation with Fondaparinux was associated to antibiotic therapy with improvement in neurological symptoms that totally remitted over the next 2 weeks. Results: These findings confirmed the diagnosis of a Lemierre’s Syndrome with thrombosis extension to cerebral sinuses. The genetic thrombophilic panel showed a heterozygosis for prothrombin gene G20210A mutation and the patient was discharged with Rivaroxaban for home continuation of anticoagulant therapy for at least 6 months. Conclusion: The prevalence of inherited thrombophilias in Lemierre’s Syndrome is unknown and to our knowledge, this article is the first to identify a prothrombin gene G20210A mutation in a patient with Lemierre’s Syndrome with thrombosis extension into the cerebral venous system. Exploring patients with Lemierre’s Syndrome for underlying thrombophilia could clarify whether this promotes retrograde jugular vein thrombosis extension.
Keywords: Case report; Lemierre’s Syndrome; thrombophilia; cerebral vein thrombosis; DOACs.
Authors
Correspondence to:
Matteo Doneddu, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy matteodoneddu@gmail.com
Publication history:
Received 22 May 2022
Revised 01 Aug 2022
Accepted 06 Aug 2022
Published online 12 Sep 2022
Published in print 16 Oct 2022
Doneddu M, Marongiu F. A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. EJMCR. 2022; 6(6): 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu M, Marongiu F. A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. https://www.ejmcr.com/?mno=44494 [Access: March 28, 2024]. doi:
10.24911/ejmcr/173-1653153200
Doneddu M, Marongiu F. A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. EJMCR. 2022; 6(6): 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu M, Marongiu F. A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. EJMCR. (2022), [cited March 28, 2024]; 6(6): 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu, M. & Marongiu, . F. (2022) A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. EJMCR, 6 (6), 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu, Matteo, and Francesco Marongiu. 2022. A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. European Journal of Medical Case Reports, 6 (6), 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu, Matteo, and Francesco Marongiu. "A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation." European Journal of Medical Case Reports 6 (2022), 111-115. doi:
10.24911/ejmcr/173-1653153200
Doneddu, Matteo, and Francesco Marongiu. "A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation." European Journal of Medical Case Reports 6.6 (2022), 111-115. Print. doi:
10.24911/ejmcr/173-1653153200
Doneddu, M. & Marongiu, . F. (2022) A unique case of Lemierre’s Syndrome and cerebral vein thrombosis in a carrier of prothrombin gene G20210A mutation. European Journal of Medical Case Reports, 6 (6), 111-115. doi:
10.24911/ejmcr/173-1653153200