Septic shock Fusobacterium necrophorum from origin gynecological at complicated an acute respiratory distress syndrome: a variant of Lemierre's syndrome

• Published in: Annales de biologie clinique (Paris) Vol. 69; no. 2; p. 202
• Main Authors: Huynh-Moynot, Sophie, Commandeur, Diane, Danguy des Déserts, Marc, Drouillard, Isabelle, Leguen, Patrick, Ould-Ahmed, Mehdi
• Format: Journal Article
• Language: French
• Published: France 01-03-2011
• Subjects: Female; Fusobacterium Infections - complications; Fusobacterium necrophorum; Humans; Intrauterine Devices; Lemierre Syndrome - etiology; Middle Aged; Respiratory Distress Syndrome, Adult - etiology; Shock, Septic - complications
• ISSN: 0003-3898
• DOI: 10.1684/abc.2011.0538

We report a case of a female patient of 47 years old who presents in a state of septic shock with acute insufficient respiratory complicated with syndrome of acute respiratory distress, together with a list of abdominal pain and polyarthralgia too. In her case of medical history, it is retained that she has had a intra-uterine device since 6 years without medical follow up. The initial thoraco-abdomino-pelvic scan shows a left ovarian vein thrombosis, as well as the opaqueness alveolus diffused interstitiel bilaterally and an aspect of ileitis. The IUD is taken off because of sudden occuring of purulent leucorrhoea. This results in a clinical and paraclinical improvement, whereas aminopenicillin was administered to the patient since 1 week. The microbiological blood test allows to put in evidence Fusobacterium necrophorum found in a blood culture and is sensitive to the amoxicilline-acide clavulanique and metronidazole. Isolation of this bacteria, classically found in Lemierre's syndrome, allowed to explain the multilfocalization of the symtoms and the list of pain. The whole concerns about a variant of Lemierre's syndrom: a state of septic shock secondary then caused by the anaerobic Gram negative bacilli, which is a commensal bacteria of the female genital tractus, complicated of septic emboli typical.