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MN: Lemierre's syndrome cases

Shiloh

Editor, Senior Moderator
Source: http://www.twincities.com/allheadlines/ci_13567130

Former Duluth East football star fighting rare disease
By John Myers
Duluth News Tribune
Updated: 10/15/2009 06:17:27 AM CDT

Matt Kilpo, the speedy quarterback who helped Duluth East High School battle to its first-ever state tournament appearance in 2007, now is battling a rare bacterial disease in a Duluth hospital.

Kilpo, 19, now a University of Minnesota sophomore studying environmental science, became ill in recent weeks and eventually was diagnosed with Lemierre's syndrome. He came home from college with a sore throat on Oct. 1 and entered St. Mary's Medical Center on Oct. 7, where he's been ever since.


"Thank you everyone for your support and prayers for Matt," wrote his brother, Andy Kilpo, on a Facebook page titled "Pray for Matt Kilpo." Earlier this week Andy wrote that Matt was doing better "but he is still in intensive care and needs your prayers. He has been diagnosed with Lemierre's syndrome; this is very rare, but he is in good hands at the hospital."

A spokesman for the family said Wednesday that Matt's parents, Bob and Karen Kilpo, report he is "improving somewhat" at mid-week. And the Kilpos thanked everyone ? from doctors and nurses to friends and family ? for their strong support.

Friends and relatives have been writing get-well messages on the Facebook page that nearly 600 people had joined by Wednesday.

Experts say the disease usually strikes otherwise healthy patients, predominantly men between the ages of 15 and 30, with a complex infection. While patients usually respond well to early antibiotics, the problem is that many patients don't seek care soon enough. Moreover, most doctors rarely, if ever, see the disease and thus don't always diagnose it quickly.

Medical literature says the disease is believed to strike fewer than one in a million people. But there have been five cases at St. Luke's hospital alone in recent years, said Dr. Linda Van Etta, a St. Luke's infectious disease expert.

"I think it's more common than we had believed. We're seeing about one case a year now,"
Van Etta said, adding that there seems to be a link between Lemierre's and the Epstein-Barr virus that causes severe mononucleosis.

Lemierre's is caused by a bacterium called Fusobacterium necrophorum that normally lives harmlessly in people's mouths but, for reasons unknown to scientists, can begin to attack the body. It usually presents as tonsillitis at first but can rapidly spread to the lungs, skin, hips and even brain. If not treated properly, it can be extremely painful, even fatal.

Lemierre's syndrome was formally identified in 1936 but nearly vanished by the 1960s, thanks to widespread use of antibiotics like penicillin to treat sore throats, where the disease often first appears. Lemierre's may have made a slight comeback in the last 20 years, experts say, after antibiotic use was scaled back due to concerns over emerging drug-resistant bacteria.

Moreover, while certain antibiotics work well ? namely, metronitizol ? other, newer antibiotics don't always work to quash the bug, Van Etta said.

Van Etta said that physicians should look for three symptoms that foretell Lemierre's: severe pharyngitis or tonsillitis; a tender and swollen neck on one side; and lung problems such as early pneumonia that show up in X-rays.


The News Tribune in 2007 wrote about UMD student Meredith Estes who was diagnosed with Lemierre's after being very ill for weeks. The disease caused an abscess in her brain. She had to undergo major brain surgery and required heavy doses of antibiotics to kill bacteria in her body. But Estes made a quick and full recovery.

"All of our patients [with Lemierre's] have survived," Van Etta said. "We've come a long way since Dr. Lemierre lost 18 of his 20 patients."
 
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