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Tonsillitis I: Introduction01:30

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Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
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Acute Pharyngitis01:30

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Characterizing Salmonella Typhimurium-induced Septic Peritonitis in Mice
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[Sore throat with septic complications].

Ayla Koçak1, Christine Hansen-Wester2, Annegret Krenz-Weinreich3

  • 1Sektion Pneumologie, Medizinische Klinik I, Sana Kliniken, Lübeck, Deutschland. ayla-kocak@t-online.de.

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|September 24, 2024
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Summary

A young man developed Lemierre syndrome, a rare complication of pharyngitis, presenting with severe symptoms. Molecular diagnostics identified Fusobacterium necrophorum, highlighting its crucial role in diagnosing such infections.

Keywords:
Fusobacterium necrophorumJugular vein thrombosisLemierre syndromeNext-generation sequencingPneumonia

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Medical Case Reports

Background:

  • Lemierre syndrome is a rare but serious complication of oropharyngeal infections, often involving thrombophlebitis of the internal jugular vein.
  • Typical symptoms include sore throat, fever, neck pain, and potentially severe complications like sepsis and abscesses.
  • Traditional diagnostic methods like bacterial cultures may be negative, posing a challenge in identifying the causative agent.

Purpose of the Study:

  • To report a case of Lemierre syndrome presenting with unusual symptoms.
  • To emphasize the utility of molecular diagnostic techniques in identifying pathogens in complex infections.
  • To highlight the importance of considering dental infections as a potential source of systemic disease.

Main Methods:

  • A case study approach was employed, detailing the clinical presentation, diagnostic workup, and treatment of a young male patient.
  • Bacterial cultures of relevant samples were performed.
  • Bacterial DNA sequencing was utilized for pathogen identification.
  • Environmental diagnostics were conducted to identify the source of infection.

Main Results:

  • The patient presented with exertional dyspnea, thoracic pain, pulmonary involvement, left-sided pleural empyema, and spondylitis following pharyngitis.
  • Standard cultures were negative for bacterial pathogens.
  • Bacterial DNA sequencing successfully identified Fusobacterium necrophorum, a common oropharyngeal bacterium.
  • Infected molars and jugular vein thrombosis were identified as the likely source and complication, respectively.

Conclusions:

  • This case underscores the successful application of molecular diagnostics in identifying Fusobacterium necrophorum in a patient with Lemierre syndrome.
  • It highlights the potential for oropharyngeal infections, even those initially presenting with atypical symptoms, to lead to severe systemic complications.
  • Early and accurate pathogen identification through advanced molecular methods is crucial for timely and effective management of Lemierre syndrome.