Related Experiment Video
Updated: Jul 31, 2026
Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Lemierre's syndrome: a forgotten complication of oropharyngeal infection
Shahid Ali Shah1, Rehman Ghani
1Department of ENT, Head & Neck Surgery, Ayub Medical College, Abbottabad. shahidalishah@ayubmed.edu.pk
Background:
Lemierre's syndrome (postanginal sepsis) usually complicates an oropharyngeal infection as septicemia, septic thrombophlebitis of the internal jugular vein, and metastatic lesions, most frequently in the lungs. Fusobacterium necrophorum is the usual etiologic agent. Lemierre's syndrome is not widely known by clinicians. This study aims at creating awareness amongst the clinicians of existence of this potentially fatal but curable clinical entity.
Methods:
All the patients admitted in the ENT department of Ayub Teaching Hospital, during the period of January 2000 to December 2002, for the treatment of acute oropharyngeal infection, were critically assessed by consultants, for features of Lemierre's syndrome, and investigated further, accordingly.
Results:
156 patients were admitted with acute oropharyngeal infection. Two patients (1.28%) had features suggestive of Lemierre's syndrome. A male and a female, 25 and 28 years old respectively, had a history of a preceding sore throat for a variable duration followed by complications. Attempts were made to make the diagnosis of Lemierre's syndrome and they were treated appropriately, as per recommendations, to a successful outcome.
Conclusions:
Widespread use of antibiotics for pharyngeal infections has significantly reduced the incidence. Rare and a forgotten complication, Lemierre's syndrome is potentially fatal. Early diagnosis and prolonged treatment with appropriate antibiotics are usually curative. A high degree of clinical suspicion is necessary for diagnosis. Modern day clinician should be aware of this potentially life threatening clinical entity that may complicate a trivial oropharyngeal infection.
Insights
Lemierre's syndrome, a rare but potentially fatal complication of oropharyngeal infections, requires high clinical suspicion for early diagnosis and treatment. Prompt recognition and appropriate antibiotics are crucial for a successful outcome in managing this condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Critical Care Medicine
Background:
- Lemierre's syndrome, or postanginal sepsis, is a severe complication of oropharyngeal infections.
- Characterized by septicemia, internal jugular vein thrombophlebitis, and metastatic lesions, often involving the lungs.
- Fusobacterium necrophorum is the typical causative agent, yet the condition remains underrecognized by clinicians.
Purpose of the Study:
- To enhance clinician awareness of Lemierre's syndrome.
- To highlight its potentially fatal yet curable nature.
- To emphasize the importance of recognizing this complication of oropharyngeal infections.
Main Methods:
- Patients admitted to the ENT department with acute oropharyngeal infections were assessed.
- Consultants evaluated patients for features suggestive of Lemierre's syndrome.
- Appropriate investigations and treatments were administered based on clinical assessment.
Main Results:
- Out of 156 patients with acute oropharyngeal infections, two (1.28%) presented with symptoms of Lemierre's syndrome.
- The affected patients, a 25-year-old male and a 28-year-old female, had a history of preceding sore throat.
- Both patients received appropriate treatment for Lemierre's syndrome, resulting in successful outcomes.
Conclusions:
- Lemierre's syndrome is a rare but life-threatening complication of oropharyngeal infections.
- Early diagnosis and prolonged antibiotic therapy are essential for successful treatment.
- A high index of clinical suspicion is necessary for prompt recognition and management.
Related Concept Videos
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:27Streptococcal Pharyngitis
01:27Esophageal Achalasia