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.
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1 March 2014
Cases of Note|
March 01 2014
Lemierre Syndrome: Not So Forgotten!
Nishant Gupta, MD;
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.
Corresponding author: Nishant Gupta, 231 Albert Sabin Way, MSB Room 6053, ML 0564, Cincinnati, OH 45267 (e-mail: [email protected]).
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Stephen M. Kralovic, MD, MPH;
Stephen M. Kralovic, MD, MPH
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.
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Dennis McGraw, MD
Dennis McGraw, MD
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.
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Am J Crit Care (2014) 23 (2): 176–179.
Citation
Nishant Gupta, Stephen M. Kralovic, Dennis McGraw; Lemierre Syndrome: Not So Forgotten!. Am J Crit Care 1 March 2014; 23 (2): 176–179. doi: https://doi.org/10.4037/ajcc2014975
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