Oak Hill Hospital
May 31, 2017

Adam Alperstein, MD

Spring Hill, FL - Oak Hill Hospital is particularly proud to announce that Adam Alperstein, MD, PGY2 (Post-Graduate Year Second Year Resident) is the first member of the GME program to publish an article while in residency in the Graduate Medical Education program.

The article is a case report and literature review on a rare and unusual type of blood clot in the neck veins due to certain deep neck infections. It's titled Septic Thrombophlebitis of the Internal Jugular Vein: A Case of Lemierre's Syndrome.

The paper was recently accepted for publication in the Intractable & Rare Diseases Research Journal.

Dr. Alperstein initially presented this case as a poster at the American College of Physicians conference earlier this year.

"The subject matter is interesting to me because there is a debate regarding the decision to treat or not to treat this unusual type of blood clot with blood thinners. Typically, blood clots are treated with blood thinners, in the form of anticoagulation, unless there is a risk of bleeding," said Dr. Alperstein. "Anticoagulants are high-risk medications for treating and preventing blood clots, with specific indications and small therapeutic windows where limiting its use may worsen a blood clot and the inappropriate use may cause bleeding.

This type of blood clot is unusual because it is caused by an infection, which is associated with a higher than usual risk of bleeding when treating with anticoagulants compared to typical blood clots. The literature, however, also states that this type of infectious blood clot has a risk of spreading to distant organs, which then may require use of anticoagulation at that point, but may possibly be avoided if treated very early with just antibiotics.

We were able to successfully treat this blood clot by treating the infection early in the disease course without having to use anticoagulants. I am very fortunate I had the opportunity to treat this rare disease and want to share my experience with others in supporting the debate that treatment of Lemierre's disease can be successful without anticoagulants."