Case report: atypical Lemierre's disease secondary to Porphyromonas asaccharolytica

Lemierre's disease, also known as 'postanginal sepsis', 'necrobacillosis', or 'internal jugular vein thrombosis', is a rare but serious emerging infection. Although Lemierre's disease remains rare, the number of reported cases has risen in recent years as more judicious antimicrobial prescribing practices for viral upper respiratory tract infections are being employed by primary care practitioners, allowing the propagation of bacterial superinfection. The most commonly implicated pathogen is Fusobacterium necrophorum, a gram-negative anaerobe that resides in the oropharynx and possesses numerous virulence factors that promote coagulation and thrombus formation. Here we describe the case of a 16-year-old male who presented with fever, neck pain, and odynophagia and was ultimately diagnosed with an atypical variant of Lemierre's disease secondary to Porphyromonas asaccharolytica, a rarely described etiologic pathogen.