RT Journal Article
SR Electronic
T1 Lemierre’s syndrome
JF Practical Neurology
JO Pract Neurol
FD BMJ Publishing Group Ltd
SP practneurol-2021-002928
DO 10.1136/practneurol-2021-002928
A1 Eng Chuan Foo
A1 Matthew Tanti
A1 Helen Cliffe
A1 Marc Randall
YR 2021
UL http://pn.bmj.com/content/early/2021/05/07/practneurol-2021-002928.abstract
AB Lemierre’s syndrome is a rare and potentially life-threatening condition that follows an oropharyngeal infection, typically from Fusobacterium necrophorum, and usually affects healthy adolescents or young adults. The characteristic features are septic thrombophlebitis of the internal jugular vein and septic embolism leading to multiorgan involvement, commonly the brain, lungs and bones. We report a man with presenting symptoms suggesting hemicrania continua, whose initial imaging showed no features of dural venous sinus or jugular thrombosis. Two weeks later, he had fever, sore throat, cervical lymphadenopathy and Actinomyces meyeri grew from peripheral blood cultures. Further imaging identified thrombosis of the internal jugular vein and cerebral venous sinuses, with multifocal cavitating lung lesions. Following antibiotics and anticoagulation, he recovered without residual deficits. Lemierre’s syndrome when recognised and treated early has a good prognosis but delayed treatment may result in significant morbidity or mortality.