A case of Lemierre's syndrome

Lemierre's syndrome is a rare but potentially life-threatening entity that follows an oropharyngeal infection. The syndrome is characterized by an antecedent acute oropharyngeal infection, with secondary suppurative thrombophlebitis of the internal jugular vein and septic emboli. In the pre-antibiotic era, it had a 90% mortality rate. Now, with the advent of antibiotics, the prognosis is favorable, but delays in diagnosis may result in increased morbidity and mortality. Its incidence appears to be increasing. We present a case of Lemierre's syndrome, most notable for the patient's essentially benign physical examination and lack of clinical improvement with penicillin. (C) 2003 Lippincott Williams & Wilkins.