Owen Davies, MBBS, Advanced Trainee in Emergency Medicine Australasia; Martin Than, MBBS, Fellow Australasian College of Emergency Medicine.
Lemierre's syndrome: Diagnosis in the emergency department
Article first published online: 6 DEC 2012
© 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia
Volume 24, Issue 6, pages 673–676, December 2012
How to Cite
Davies, O. and Than, M. (2012), Lemierre's syndrome: Diagnosis in the emergency department. Emergency Medicine Australasia, 24: 673–676. doi: 10.1111/1742-6723.12010
- Issue published online: 6 DEC 2012
- Article first published online: 6 DEC 2012
- Manuscript Accepted: 21 AUG 2012
- Fusobacterium necrophorum;
- Lemierre's syndrome;
A 15-year-old boy presented with signs of sepsis and a history of sore throat, fevers and shortness of breath. Full examination revealed an erythematous oropharynx and mild tonsillar swelling. He rapidly deteriorated requiring admission to intensive care. Blood cultures grew Fusobacterium necrophorum and an ultrasound scan performed for left neck tenderness confirmed internal jugular vein thrombosis. He was diagnosed with Lemierre's syndrome. This condition results from pharyngitis or tonsillitis with bacterial spread to the lateral pharyngeal space. Internal jugular vein thrombosis ensues with septic emboli and metastatic infections that most frequently involve the lungs. Although increasing in incidence, diagnosis is often delayed. We discuss why and describe its clinical presentation, investigations of choice and treatment strategies.