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Published in: Journal of General Internal Medicine 7/2009

01-07-2009 | Case Reports/Clinical Vignettes

A Sore Throat—Potentially Life-Threatening?

Authors: Hai-Yan Li, MD, Mandy Grubb, MD, Mukta Panda, MD, Roger Jones, MD

Published in: Journal of General Internal Medicine | Issue 7/2009

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Abstract

A sore throat, which is most commonly viewed as a minor ailment, can be a manifestation of a life-threatening disorder known as Lemierre’s syndrome caused by Fusobacterium necrophorum. We report a new case of Lemierre’s syndrome that occurred in an otherwise healthy 18-year-old woman, who initially presented with fever and sore throat. The diagnosis was not made until a week later when blood cultures became available. This syndrome should be suspected until proven otherwise in any patient with signs of pharyngitis, a painful swollen neck, and pulmonary symptoms. By presenting this curable, but potentially life-threatening case of Lemierre’s syndrome, we hope to increase the awareness of the early clinical manifestations of Lemierre’s syndrome and to emphasize the importance of careful physical examination with special attention to the neck. Clinicians should be aware that exclusion of streptococcal infection in a patient with severe tonsillar infection does not exclude a bacterial cause.
Literature
1.
go back to reference Aliyu SH, Marriott RK, Curran MD, et al. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. J Med Microbiol. 2004;53:1029–35.PubMedCrossRef Aliyu SH, Marriott RK, Curran MD, et al. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. J Med Microbiol. 2004;53:1029–35.PubMedCrossRef
2.
go back to reference Batty A, Wren MWD. Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs. Br J Biomed Sci. 2005;62:66–70.PubMed Batty A, Wren MWD. Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs. Br J Biomed Sci. 2005;62:66–70.PubMed
3.
go back to reference Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007;13:695–701.PubMedCrossRef Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007;13:695–701.PubMedCrossRef
4.
go back to reference Amess JA, O’Neill W, Giollariabhaigh CN, Dytrych JK. A six-month audit of the isolation of Fusobacterium necrophorum from patients with sore throat in a district general hospital. Br J Biomed Sci. 2007;64:63–5.PubMed Amess JA, O’Neill W, Giollariabhaigh CN, Dytrych JK. A six-month audit of the isolation of Fusobacterium necrophorum from patients with sore throat in a district general hospital. Br J Biomed Sci. 2007;64:63–5.PubMed
5.
go back to reference Lemierre A. On certain septicemias due to anaerobic organisms. Lancet. 1936;1:701–3.CrossRef Lemierre A. On certain septicemias due to anaerobic organisms. Lancet. 1936;1:701–3.CrossRef
6.
go back to reference Sinave CP, Hardy GJ, Fardy PW. The Lemierre’s syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Med (Baltimore). 1989;68:85–94. Sinave CP, Hardy GJ, Fardy PW. The Lemierre’s syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Med (Baltimore). 1989;68:85–94.
7.
go back to reference Shah SA, Ghani R. Lemierre’s syndrome: a forgotten complication of oropharyngeal infection. J Ayub Med Coll Abbottabad. 2005;17:30–3.PubMed Shah SA, Ghani R. Lemierre’s syndrome: a forgotten complication of oropharyngeal infection. J Ayub Med Coll Abbottabad. 2005;17:30–3.PubMed
8.
go back to reference Koay CB, Heyworth T, Burden P. Lemierre syndrome: a forgotten complication of acute tonsillitis. J Laryngol Otol. 1995;109:657–61.PubMed Koay CB, Heyworth T, Burden P. Lemierre syndrome: a forgotten complication of acute tonsillitis. J Laryngol Otol. 1995;109:657–61.PubMed
9.
go back to reference Moore BA, Dekle C, Werkhaven J. Bilateral Lemierre’s syndrome: a case report and literature review. Ear Nose Throat J. 2002;81:234–52.PubMed Moore BA, Dekle C, Werkhaven J. Bilateral Lemierre’s syndrome: a case report and literature review. Ear Nose Throat J. 2002;81:234–52.PubMed
10.
go back to reference Hagelskjær Kristensen L, Prag J. Lemierre’s syndrome and other disseminated Fusobacterium necrophorum infections in Denmark: a prospective epidemiological and clinical survey. Eur J Clin Microbiol Infect Dis. 2008;27:779–89.PubMedCrossRef Hagelskjær Kristensen L, Prag J. Lemierre’s syndrome and other disseminated Fusobacterium necrophorum infections in Denmark: a prospective epidemiological and clinical survey. Eur J Clin Microbiol Infect Dis. 2008;27:779–89.PubMedCrossRef
11.
go back to reference Riordan T. Human infection with Fusobacterium necrophorum (necrobacillosis), with a focus on Lemierre’s syndrome. Clin Microbiol Rev. 2007;20:622–59.PubMedCrossRef Riordan T. Human infection with Fusobacterium necrophorum (necrobacillosis), with a focus on Lemierre’s syndrome. Clin Microbiol Rev. 2007;20:622–59.PubMedCrossRef
12.
go back to reference Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre’s syndrome: report of 2 cases and review of the literature. Med (Baltimore). 2002;81:458–65.CrossRef Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre’s syndrome: report of 2 cases and review of the literature. Med (Baltimore). 2002;81:458–65.CrossRef
13.
go back to reference Brown LM, Wallwork B. Lemierre’s- the sinister sore throat. J Laryngo Otol. 2007;121:692–4. Brown LM, Wallwork B. Lemierre’s- the sinister sore throat. J Laryngo Otol. 2007;121:692–4.
14.
go back to reference Sherer Y, Mishal J, Leibovici O. Early antibiotic treatment may prevent complete development of Lemierre’s syndrome: experience from 2 cases. Scand J Infect Dis. 2000;32:706–7.PubMedCrossRef Sherer Y, Mishal J, Leibovici O. Early antibiotic treatment may prevent complete development of Lemierre’s syndrome: experience from 2 cases. Scand J Infect Dis. 2000;32:706–7.PubMedCrossRef
15.
go back to reference Fleskens AJ, Scheltinga MR, van Eerten PV, Verhoef LH, Pasmans HL, Vreugdenhil G. Sore throat and a swollen neck: Lemierre’s syndrome until proven otherwise. Ned Tijdschr Geneeskd. 2006;150:2461–6.PubMed Fleskens AJ, Scheltinga MR, van Eerten PV, Verhoef LH, Pasmans HL, Vreugdenhil G. Sore throat and a swollen neck: Lemierre’s syndrome until proven otherwise. Ned Tijdschr Geneeskd. 2006;150:2461–6.PubMed
16.
go back to reference Nguyen-Dihg KV, Masot-Dupuch K, Portier F, Lamblin B, Lasjaunias P. Lemierre syndrome: usefulness of CT in detection of extensive occult thrombophlebitis. J Neuroradiol. 2002;29:132–5. Nguyen-Dihg KV, Masot-Dupuch K, Portier F, Lamblin B, Lasjaunias P. Lemierre syndrome: usefulness of CT in detection of extensive occult thrombophlebitis. J Neuroradiol. 2002;29:132–5.
17.
go back to reference Dool H, Soetekouw R, Zanten MV, Grooters E. Lemierre’s syndrome: three cases and a review. Eur Arch Otorhinolaryngol. 2005;262:651–4.PubMedCrossRef Dool H, Soetekouw R, Zanten MV, Grooters E. Lemierre’s syndrome: three cases and a review. Eur Arch Otorhinolaryngol. 2005;262:651–4.PubMedCrossRef
18.
go back to reference Le Roux K, Seve P, Gomard E, et al. Lemierre’s syndrome variant: hepatic abscesses and hepatic venous thrombosis due to Fusobacterium nucleatum septicemia [in French]. Rev Med Intern. 2006;27:482–6.CrossRef Le Roux K, Seve P, Gomard E, et al. Lemierre’s syndrome variant: hepatic abscesses and hepatic venous thrombosis due to Fusobacterium nucleatum septicemia [in French]. Rev Med Intern. 2006;27:482–6.CrossRef
19.
go back to reference Williams MD, Kerber CA, Tergin HF. Unusual presentation of Lemierre’s syndrome due to Fusobacerium nucleatum. J Clin Microbiol. 2003;41:3445–8.PubMedCrossRef Williams MD, Kerber CA, Tergin HF. Unusual presentation of Lemierre’s syndrome due to Fusobacerium nucleatum. J Clin Microbiol. 2003;41:3445–8.PubMedCrossRef
20.
go back to reference De Sena S, Rosenfeld DL, Santos S, Keller I. Jugular thrombophlebitis complicating bacterial pharyngitis (Lemierre’s syndrome). Pediatr Radiol. 1996;26:141–4.PubMedCrossRef De Sena S, Rosenfeld DL, Santos S, Keller I. Jugular thrombophlebitis complicating bacterial pharyngitis (Lemierre’s syndrome). Pediatr Radiol. 1996;26:141–4.PubMedCrossRef
21.
go back to reference Riordn T, Wilson M. Lemierre’s syndrome: more than a historical curiosa. Postgrad Med J. 2004;80:328–34.CrossRef Riordn T, Wilson M. Lemierre’s syndrome: more than a historical curiosa. Postgrad Med J. 2004;80:328–34.CrossRef
Metadata
Title
A Sore Throat—Potentially Life-Threatening?
Authors
Hai-Yan Li, MD
Mandy Grubb, MD
Mukta Panda, MD
Roger Jones, MD
Publication date
01-07-2009
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 7/2009
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1001-1

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