Blindness caused by septic superior ophthalmic vein thrombosis in a Lemierre Syndrome variant

• Published in: Auris, nasus, larynx Vol. 40; no. 5; pp. 493 - 496
• Main Authors: Akiyama, Kosuke, Karaki, Masayuki, Samukawa, Yasushi, Mori, Nozomu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01-10-2013
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Blindness; Blindness - etiology; Cellulitis - complications; Cellulitis - drug therapy; Eye - blood supply; Face; Facial cellulitis; Humans; Lemierre Syndrome; Lemierre Syndrome - complications; Lemierre Syndrome - drug therapy; Male; Multiple Pulmonary Nodules; Orbit - blood supply; Orbital cellulitis; Orbital Cellulitis - complications; Orbital Cellulitis - drug therapy; Otolaryngology; Pulmonary Embolism; Septic superior ophthalmic vein thrombosis; Tomography, X-Ray Computed; Venous Thrombosis - drug therapy; Venous Thrombosis - etiology; Septic superior ophthalmic vein thrombosis; Facial cellulitis; Orbital cellulitis; Lemierre Syndrome; Blindness
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2012.09.006

Abstract A 65-year-old man presented with right facial cellulitis and right blindness. Enhanced CT and MRI showed right facial cellulitis involved with pterigopalatine fossa. Additionally, orbital cellulitis, superior ophthalmic vein thrombosis, and pulmonary multiple nodules were observed.18 F-FDG PET/CT supported these findings. He was diagnosed with septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome variant and was treated mainly by the administration of intravenous antibiotics. His symptoms and image findings improved after a few days of treatment, but the right visual loss has not recovered. Since septic superior ophthalmic vein thrombosis and Lemierre Syndrome both have life-threatening potential, early diagnosis and appropriate treatment are important and may contribute to reduce the incidence of severe complications. Septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome is exceeding rare, and this case is the first report of blindness in Lemierre Syndrome. A literature review and discussion of septic superior ophthalmic vein thrombosis and Lemierre Syndrome are included.