Lemierre's Syndrome

Lemierre's syndrome is characterized by acute oropharyngeal infection with documented septicemia complicated by septic jugular thrombophlebitis and septic pulmonary emboli. Fusobacterium necrophorum is the most common etiologic agent. We report a previously apparently healthy 22-year-old man who presented with fever, sore throat and purulent tonsillitis. Chest radiography revealed opacity in the posterobasal segment of the left lower lung and F. necrophorum was isolated from his blood culture. Doppler duplex sonography demonstrated a dilated right internal jugular vein and thrombus formation within the right internal jugular vein. Computed tomography of the chest demonstrated multiple airspace opacities of varying sizes within bilateral lung fields. Computed tomography of the neck revealed partial occlusion of the right internal jugular vein and swelling of the surrounding tissue. The patient made a full recovery following intravenous amoxicillin and clavulanate therapy over a period of 3 weeks.