title: The forgotten disease: Bilateral lemierre's disease with mycotic aneurysm of the vertebral artery.
abstract: METHODS
  Male, 25 FINAL DIAGNOSIS: Lemierre's disease Symptoms: Back pain • fever • headache • tachycardia • tachypnoe
  
  
  METHODS
  - Clinical Procedure: - Specialty: Infectious Diseases.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  Lemierre's disease, also known as the forgotten disease, postanginal sepsis, or necrobacillosis, was first reported in 1890 by Courmont and Cade, but it was Dr. Andre Lemierre, a professor of microbiology, who described this disease in 1936. The typical causative agent is Fusobacterium necrophorum, although other organisms may be involved. The pathogenesis of Lemierre's disease is not well understood. It is characterized by a primary oropharyngeal infection associated with septicemia, internal jugular vein thrombosis, and metastatic septic emboli.
  
  
  METHODS
  We report a case of Lemierre's disease with bilateral internal jugular vein (IJV) thrombosis and metastatic septic emboli to the lungs and brain, associated with epidural abscess and mycotic aneurysm of the vertebral artery, which is quite rare in Lemierre's disease. This is the first report of a case of Lemierre's disease associated with mycotic aneurysm of the vertebral artery.
  
  
  CONCLUSIONS
  Lemierre's disease is a rare and perplexing medical entity. Clinical suspicion should be high in previously healthy young adults presenting with fever and neck pain following oropharyngeal infection. Dr. Lemierre stated that 'symptoms and signs of Lemierre's disease are so characteristic that it permits diagnosis before bacteriological examination'. The prognosis of patients with Lemierre's disease is generally good, provided prompt recognition and appropriate treatment.
authors.affiliation: Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, U.S.A.
authors.forename: Tanush
authors.initials: T
authors.lastname: Gupta
authors.affiliation: Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, U.S.A.
authors.forename: Kaushal
authors.initials: K
authors.lastname: Parikh
authors.affiliation: Department of Internal Medicine, University of Connecticut, Farmington, CT, U.S.A.
authors.forename: Sonam
authors.initials: S
authors.lastname: Puri
authors.affiliation: Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, U.S.A.
authors.forename: Sahil
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Department of Internal Medicine, University of Florida, Gainesville, FL, U.S.A.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Agrawal
authors.affiliation: Department of Pulmonary and Critical Care, Westchester Medical Center, New York Medical College, Valhalla, NY, U.S.A.
authors.forename: Divakar
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Pulmonary and Critical Care, Westchester Medical Center, New York Medical College, Valhalla, NY, U.S.A.
authors.forename: Lawrence
authors.initials: L
authors.lastname: DeLorenzo
keywords: Aneurysm; Infected – microbiology; Lemierre Syndrome; Thrombosis