title: Fusobacterium necrophorumPharyngitis Complicated by Lemierre's Syndrome.
abstract: We report the case of an 18-year-old woman who was referred to our outpatient clinic because of a 2-week history of sore throat, high fever, and neck tenderness unresponsive to a 7-day amoxicillin/clavulanic acid course. Infectious mononucleosis was initially suspected, but an extremely high value of procalcitonin and clinical deterioration suggested a bacterial sepsis, prompting the patient admission to our internal medicine ward. Blood cultures were positive forFusobacterium necrophorum. CT scan detected a parapharyngeal abscess, a right internal jugular vein thrombosis, and multiple bilateral lung abscesses, suggesting the diagnosis of Lemierre's syndrome. The patient was treated with a 2-week course of metronidazole and meropenem with a gradual clinical recovery. She was thereafter discharged home with metronidazole and amoxicillin/clavulanic acid for 14 days and a 3-month course of enoxaparin, experiencing an uneventful recovery. The present case highlights the importance of taking into consideration the Lemierre's syndrome whenever a pharyngotonsillitis has a severe and unusual course.
authors.affiliation: Internal Medicine, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Antonio
authors.identifier: 0000-0001-6095-8403
authors.initials: A
authors.lastname: Faraone
authors.affiliation: Internal Medicine, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Alberto
authors.identifier: 0000-0002-0156-3142
authors.initials: A
authors.lastname: Fortini
authors.affiliation: Internal Medicine, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Nenci
authors.affiliation: Internal Medicine, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Costanza
authors.initials: C
authors.lastname: Boccadori
authors.affiliation: Intensive Care Unit, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Mangani
authors.affiliation: Intensive Care Unit, "San Giovanni di Dio" Hospital, Via di Torregalli 3, Florence, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Oggioni