Lemierre syndrome: postanginal sepsis

Lemierre syndrome, or postanginal sepsis, was first described in the early part of this century and is characterized by pharyngitis, followed by high fever and rigors, cervical adenopathy, thrombophlebitis of the internal jugular vein, distant abscess formation, and icterus, associated with isolation of Fusobacterium necrophorum from blood.

This report describes a case of postanginal sepsis and reviews the medical literature on postanginal sepsis obtained through the MEDLINE data base using Fusobacterium as the key search word.

The features of Lemierre syndrome have changed little since the original description, through the prognosis has improved dramatically since the development of antibiotics. Appropriate management includes prompt administration of an antibiotic with good anaerobic coverage, drainage of persistent abscesses, and continued antibiotic therapy until radiographic resolution of abscess is achieved.

Although Lemierre syndrome is a relatively uncommon disease, the primary care physician needs to be aware of the clinical features and management to treat appropriately.