Anticoagulation therapy for Lemierre syndrome: a comprehensive review and individual participant data analysis

作者：Haruka Tsuda, Yusuke Miyazato, Shuri Nakao, Takahiro Tsuge, Norio Yamamoto, Yoshitaka Wada, Yuki Kataoka · 发表于：Thrombosis Journal · 年份：2026 · DOI：10.1186/s12959-026-00889-y · 被引用次数：1 · 研究领域：Otolaryngology and Infectious Diseases、Infective Endocarditis Diagnosis and Management、Streptococcal Infections and Treatments

BACKGROUND: Lemierre's syndrome is a life-threatening infection characterized by septic thrombophlebitis of the internal jugular vein and septic embolism. Antimicrobial therapy is an established treatment for Lemierre's syndrome; however, its role in anticoagulation therapy remains unclear. OBJECTIVE: To evaluate the association between anticoagulation therapy initiated concurrently with antimicrobial therapy and the clinical outcomes in patients with Lemierre syndrome. METHODS: We comprehensively searched the PubMed, Embase, and Ichushi databases for case reports, case series, and cohort studies. Lemierre syndrome was defined as (1) a preceding oropharyngeal infection and (2) internal jugular vein thrombophlebitis or septic pulmonary emboli confirmed by imaging or pathology. We performed a case-control analysis and estimated odds ratios using multivariate logistic regression after adjusting for potential confounders. RESULTS: Of the 2051 screened records, internal jugular vein thrombus progressed in 15 patients (7.18% [15/209]) who received anticoagulation therapy and in 21 patients (18.8% [21/112]) who did not. The median age of the patients was 25 years (interquartile range, 18-45 years), and the baseline characteristics were generally balanced between the anticoagulated and non-anticoagulated patients. For the primary outcome of thrombus progression, anticoagulation therapy was associated with a significantly lower risk compared with no anticoagulation therapy (multiple i...