A Case of Embolic Spread of Fusobacterium necrophorum From Presumed Pharyngitis

Area of Science:

• Infectious Diseases
• Microbiology
• Critical Care Medicine

Background:

• Lemierre's syndrome is a severe condition often involving oropharyngeal infection, internal jugular vein thrombophlebitis, and distant metastases.
• Fusobacterium necrophorum is the primary pathogen associated with Lemierre's syndrome.

Observation:

• A case of Lemierre's syndrome presented with an embolic spread of F. necrophorum to the lungs.
• The patient's presentation lacked the characteristic internal jugular vein thrombosis.
• Initial misdiagnosis included community-acquired pneumonia, severe sepsis, and disseminated intravascular coagulation.

Findings:

• F. necrophorum can cause Lemierre's syndrome with pulmonary embolism as the primary manifestation.
• Absence of internal jugular vein thrombosis does not exclude Lemierre's syndrome diagnosis.
• Multidisciplinary care and appropriate antibiotic therapy led to complete patient recovery.

Implications:

• Broadens the clinical spectrum of Lemierre's syndrome presentation.
• Emphasizes the importance of considering F. necrophorum in severe sepsis with pulmonary involvement.
• Highlights the need for prompt and accurate diagnosis for effective management of rare infections.