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Lemierre's syndrome: are we underdiagnosing this life-threatening infection?

R P Harar1, A MacDonald, D Pullen

  • 1Whipps Cross Hospital, London, UK.

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|May 1, 1996
PubMed

Insights

Fusobacterium necrophorum can cause severe tonsillitis and Lemierre's syndrome. Early recognition and blood cultures are crucial for diagnosing this potentially fatal infection, even with prompt antibiotic response.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Vascular Medicine

Background:

  • Severe tonsillitis can be a precursor to serious systemic infections.
  • Fusobacterium necrophorum is a bacterium that can cause severe throat infections.

Observation:

  • Three patients with severe tonsillitis grew Fusobacterium necrophorum in blood cultures over 12 months.
  • One patient developed external and internal jugular vein thrombosis, indicative of Lemierre's syndrome.

Findings:

  • Two patients with Fusobacterium necrophorum tonsillitis responded rapidly to antibiotics.
  • The third patient, with a longer symptom history, presented with jugular vein thrombosis, a critical step in disease dissemination.

Implications:

  • Lemierre's syndrome may be underdiagnosed due to rapid clinical improvement with antibiotics like penicillin and metronidazole.
  • Emphasizes the importance of blood cultures and neck examination in severe tonsillitis cases.
  • Highlights the potential severity of Fusobacterium necrophorum infections beyond typical pharyngitis.

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