title: Unusual presentation of Lemierre's syndrome: two cases and a review.
abstract: Lemierre's syndrome is a potentially fatal disease that usually presents with oropharyngeal infection, followed by sepsis, thrombosis of the internal jugular vein and septic emboli. Most cases are caused by the Gram-negative, anaerobic Fusobacterium necrophorum. We present two patients with an atypical presentation of Lemierre's syndrome and a review. These cases illustrate that a positive blood culture for F. necrophorum, even without the presence of clinical symptoms pointing towards thrombosis of the internal jugular vein, justifies further radiological testing for thrombophlebitis of the internal jugular vein.
authors.affiliation: Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands. Matthijs.vanWissen@slz.nl
authors.forename: Matthijs
authors.initials: M
authors.lastname: van Wissen
authors.forename: Victor E A
authors.initials: VE
authors.lastname: Gerdes
authors.forename: Eric C M
authors.initials: EC
authors.lastname: van Gorp
authors.forename: Dees P M
authors.initials: DP
authors.lastname: Brandjes
authors.forename: Marcel
authors.initials: M
authors.lastname: Soesan
mesh_terms: D000074:Acenocoumarol / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000382:microbiology; D003680:Deglutition Disorders / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D005674:Fusobacterium Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D017762:Nadroparin / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D018410:Pneumonia, Bacterial / Q000209:etiology; D013577:Syndrome; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D017762:Nadroparin; D010406:Penicillins; D000074:Acenocoumarol