Lemierre syndrome (septic thrombosis of the jugular vein)

Etiology

• Streptococci
• beta-lactamase producing organisms
• anaerobes
  • Fusobacterium
    • Fusobacterium necrophorum

Pathology

• septic thrombosis of the internal jugular vein
• metastatic pulmonary infections

Clinical manifestations

• pharyngitis
• fever
• unlateral neck tenderness

Laboratory

• complete blood count
  • leukocytosis, neutrophila. left shift
• routine testring for Fusobacterium necrophorum not recommended

Radiology

• chest X-ray may show multiple densities consistent with septic emboli
• CT of the neck with contrast confirms diagnosis

Management

• intravenous antibiotics
  • coverage should include
    • Streptococci
    • anaerobes (Fusobacterium)
    • beta-lactamase producing organisms
  • piperacillin tazobactam, or ticarcillin clavulate
  • ampicillin sulbactam for Fusobacterium
  • carbapenem

More general terms

• syndrome
• thromboembolism
• sepsis

Additional terms

• jugular vein