Oropharyngeal infection with metastatic hand infection: an uncommon variant of Lemierre's syndrome.
Lemierre's syndrome is caused by acute oropharyngeal infection with septic secondary thrombophlebitis of the internal jugular vein and metastatic infection. Fusobacterium necrophorum is the most commonly implicated aetiological agent. The authors present the case of a healthy young man presenting with a history of general malaise and sore throat who developed septic metastatic complications in the left upper limb. He made a complete recovery after treatment with a combination of parenteral antibiotics and a multidisciplinary approach. Early ultrasound scanning of the neck and blood cultures are advocated to diagnose this potentially fatal condition. Management involves a high degree of clinical suspicion for this often 'forgotten' condition and treatment is further discussed in the article.
Department of Otolaryngology Head & Neck Surgery, University of Aberdeen, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Muhammad
M
Shakeel
Neil
N
McCluney
Lawrence
L
Li
Jonathan Ray
JR
Newton
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005674:Fusobacterium Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006225:Hand / Q000473:pathology*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D010612:Pharyngitis / Q000150:complications* / Q000188:drug therapy; D013577:Syndrome; D013924:Thrombophlebitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014069:Tonsillitis / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D014463:Ultrasonography
D000900:Anti-Bacterial Agents