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Case Reports
. 2022 Mar 1;42(1):e443-e445.
doi: 10.1097/WNO.0000000000001332. Epub 2021 Jul 27.

Retinal, Optic Nerve, and Cerebral Infarction in Odontogenic Lemierre Syndrome

Ahmad Halawa  1 , John Kim, Jonathan D Trobe
Affiliations
Case Reports

Retinal, Optic Nerve, and Cerebral Infarction in Odontogenic Lemierre Syndrome

Ahmad Halawa et al. J Neuroophthalmol. .

Abstract

A 61-year-old healthy woman developed congestive orbitopathy, and bilateral retinal, optic nerve, and cerebral infarctions after removal of a chipped molar tooth. Ophthalmoscopy disclosed multiple retinal arteriolar occlusions and pallid swelling of both optic discs. Imaging revealed ipsilateral masticator and pterygoid muscle abscesses, and thrombosis of the right internal jugular vein and sigmoid sinus, both cavernous sinuses and superior ophthalmic veins, and restricted diffusion of both optic nerves and corona radiata. Blood cultures were positive for Streptococcus anginosus. Despite aggressive medical and surgical treatment, the patient remained unresponsive and presumptively blind. This case is an example of a catastrophic form of odontogenic Lemierre syndrome. Blindness, attributable to venous hypertension and vasculitis, has been rarely reported. Early recognition and treatment are critical to avoid such dire consequences.

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Conflict of interest statement

The authors report no conflicts of interest.

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