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Lemierre's syndrome: the link between a simple sore throat, sore neck and pleuritic chest pain.

Ajulo P, Qayyum A, Brewis C, Innes A

Department of Ear, Nose and Throat, Norfolk & Norwich University Hospital, Norwich, UK. poajulo@aol.com

An unusual case of tonsillitis which showed progression to this rare syndrome despite treatment with intravenous antibiotics. Lemierre's syndrome is a rare condition characterised by a triad of: sepsis, thrombophlebitis of the internal jugular vein along with pleuropulmonary and/or distant metastatic abscesses. Diagnosis rests on a high index of suspicion and is confirmed by culture of Fusobacterium spp. from blood or infected sites. Radiological investigations are established aids for confirmation of diagnosis. Treatment is with appropriate antibiotics for at least 6 weeks and surgical drainage of abscesses if required. This case has been presented to highlight the mode of presentation, diagnostic tools employed and the management of the complications that featured in this condition.

Published 1 August 2005 in Ann R Coll Surg Engl, 87(4): 303-5.
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