Lemierre's Syndrome

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Overview

Lemierre’s Syndrome refers to human necrobacillosis (infections with F. necrophorum) with primary foci in the head (oropharynx, face, ears, mastoid, teeth), often with septic thrombophlebitis of the internal jugular vein.

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Epidemiology and Demographics

• Rare
• Previously healthy persons without underlying diseases:

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Diagnosis

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History and Symptoms

• Intense rigors and high fever within 1 week after primary local infection
• Leukocytosis
• Subclincical hyperbilirubinemia (50%)
• Mild DIC (23%)

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Physical Examination

Ear Nose and Throat

• Ipsilateral neck tenderness parallel with sternocleidomastoid muscle

Lungs

• Metastatic abscesses mainly to lungs (85%), but also joints (26%)

Abdomen

• Abdominal pain 2nd to microabscesses vs. thrombophlebitis of abdomino- pelvic veins

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Laboratory Findings

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Echocardiography or Ultrasound

• Unilateral suppurative thrombophlebitis of IJ: Ultrasound, CT, MRA

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Treatment

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References

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Acknowledgements

The content on this page was first contributed by: Stephen Wiviott, M.D.

List of contributors:

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For Patients

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