title: Lemierre's syndrome mimicking leptospirosis.
abstract: Lemierre's syndrome is a suppurative thrombophlebitis involving the internal jugular vein, most commonly associated with Fusobacterium necrophorum, usually a complication of oropharyngeal infections. This syndrome is rare and is often overlooked. We present a case of sepsis mimicking initially severe leptospirosis (Weil's disease) due to acute febrile illness with multiorgan failure and hyperbilirubinemia. Finally, blood cultures revealed Fusobacterium necrophorum and computed tomography (CT) demonstrated bilateral pulmonary nodules and a thrombus in the right internal jugular vein. Early clinical suspicion is crucial so that appropriate diagnostic investigation and antibiotic therapy can be initiated to minimize the risk of life-threatening complications.
authors.affiliation: Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i 96813, USA. dagmarl@hawaii.edu
authors.forename: Dagmar
authors.initials: D
authors.lastname: Lin
authors.forename: Nuntra
authors.initials: N
authors.lastname: Suwantarat
authors.forename: Royden S
authors.initials: RS
authors.lastname: Young
mesh_terms: D003937:Diagnosis, Differential; D005674:Fusobacterium Infections / Q000000981:diagnostic imaging*; D005675:Fusobacterium necrophorum / Q000302:isolation & purification*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000382:microbiology; D007922:Leptospirosis / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology*; D013577:Syndrome; D013924:Thrombophlebitis / Q000150:complications / Q000382:microbiology*; D014057:Tomography, X-Ray Computed