Importance of blood cultures to aid the diagnosis of Lemierre's syndrome

N Z Med J. 2015 May 15;128(1414):62-4.

Abstract

This is a case report of Lemierre's syndrome, a septic thrombophlebitis of the internal jugular vein (IJV) usually preceded by pharyngitis and bacteraemia with an anaerobic organism. Fusobacterium necrophorum is ananaerobic Gram-negative bacillus and is the most common organism reported to cause Lemierre's syndrome which usually occurs one to three weeks post pharyngitis or oropharyngeal surgery. A 21-year-old patient presented with signs of sepsis and a history of sore throat, fever, and tender cervical lymph nodes. Blood cultures grew F. necrophorum and Computed Tomography (CT) showed a filling defect in the left retromandibular vein and thrombosis in the left internal jugular vein (IJV) consistent with Lemierre's syndrome. This is an uncommon condition which normally occurs in young individuals and diagnosis is often delayed.

Publication types

  • Case Reports

MeSH terms

  • Amoxicillin / administration & dosage*
  • Anti-Infective Agents / administration & dosage
  • Female
  • Fusobacterium necrophorum* / drug effects
  • Fusobacterium necrophorum* / isolation & purification
  • Humans
  • Jugular Veins / diagnostic imaging*
  • Lemierre Syndrome* / blood
  • Lemierre Syndrome* / complications
  • Lemierre Syndrome* / physiopathology
  • Lemierre Syndrome* / therapy
  • Metronidazole / administration & dosage*
  • Microbiological Techniques / methods
  • Sepsis* / blood
  • Sepsis* / drug therapy
  • Sepsis* / etiology
  • Thrombophlebitis* / diagnosis
  • Thrombophlebitis* / etiology
  • Tomography, X-Ray Computed / methods
  • Tonsillectomy / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents
  • Metronidazole
  • Amoxicillin