Lemierre Syndrome Secondary to Parotitis with Bacillus Brevis: A Forgotten Disease

Lemierre’s syndrome was described for the first time in 1900 by Courmont and Cade, It is a rare pathology that affects mainly adolescents or previously healthy young adults with a moderate male preponderance. The typical pathogen germ is Fusobacterium necrophorum and the organ most frequently affected is the lung where septic emboli cause a bilateral pleuro-pneumopathy. The diagnosis of Lemierre’s syndrome is primarily clinical, it evolves classically in three phases: oropharyngeal infection and then homolateral internal jugular septic thrombophlebitis by local diffusion and finally metastatic dissemination by blood and lymphatic systems in the next four to eight days. Management is primarily medical, sometimes surgical in the presence of deep abscess and / or cervical and mediastinal tissue necrosis.

We report the case of a patient suffering from necrotizing bacterial parotitis, responsible for cervicofacial cellulitis complicated by bilateral internal jugular thrombophlebitis and multifocal septic emboli performing a clinical picture of Lemierre syndrome. Our case is the only one described in the literature responsible for parotitis bacillus brevis to our knowledge.

The objective of our work is to recall the pathogenesis, the clinical and the treatment of Lemierre syndrome through this clinical case.

Keywords:Bacillus brevis; Lemierre syndrome; Parotitis