Lemierre syndrome with cervical spondylodiscitis and epidural abscess associated with direct injection of heroin into the jugular vein
Hsin-Ying Lin, Kuo-Hsing Liao, Shio-Shin Jean, Tsong-Yih Ou, Fu-Lun Chen, Wen-Sen Lee
Received: November 6, 2013 Revised: November 16, 2013 Accepted: January 2, 2014
Corresponding author. Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Medical Center, Taipei Medical University, No. 111, Section 3, Hsing-Long Road, Taipei 116, Taiwan.
Background and purpose:
Pseudomonas aeruginosa infections rarely occur in intravenous drug users with Lemierre syndrome.1,2 We report here the case of a patient, an intravenous drug user with a history of injecting heroin directly into the jugular vein, with thrombophlebitis, P. aeruginosa bacteremia, metastatic cervical spondylodiscitis, and an epidural abscess. The patient's condition was initially complicated by moderate quadriplegia, hyperreflexia, and hypothesia below the C5 dermatome. He recovered well after surgical debridement, treatment with antibiotic drugs, and rehabilitation.