title: Lemierre syndrome: not so forgotten!
abstract: Lemierre syndrome is a rare and life-threatening illness. Often referred to as "the forgotten disease," its incidence is reported to be as low as 1 in a million. The microorganism responsible for Lemierre syndrome is typically Fusobacterium necrophorum. The bacterium starts in the pharynx and peritonsillar tissue, then disseminates through lymphatic vessels. Severe sepsis rapidly develops, as does the hallmark of this syndrome: septic thrombophlebitis of the internal jugular vein. This report describes a case of Lemierre syndrome in a previously healthy 26-year-old man with life-threatening internal jugular vein thrombophlebitis following 2 weeks of an indolent course of pharyngitis. The patient's initial presentation and extensive travel history as an Army veteran were particularly challenging aspects in establishing his diagnosis. The diagnosis of Lemierre syndrome is frequently delayed. Routine use of bedside ultrasonography may aid in rapid diagnosis of the disease.
authors.affiliation: Nishant Gupta is an assistant professor and Dennis McGraw is an associate professor in the Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio. Stephen M. Kralovic is an associate professor in the Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati.
authors.forename: Nishant
authors.initials: N
authors.lastname: Gupta
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Kralovic
authors.forename: Dennis
authors.initials: D
authors.lastname: McGraw
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005334:Fever; D005674:Fusobacterium Infections / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005675:Fusobacterium necrophorum / Q000302:isolation & purification; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D057831:Lemierre Syndrome / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D010612:Pharyngitis / Q000150:complications* / Q000382:microbiology; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents