Lemierre's syndrome

Description Lemierre's synd...

Description

Lemierre's syndrome is a form of blood vessel inflammation (thrombophlebitis) caused, most commonly, by a bacteria called Fusobacterium necrophorum. These bacteria are normally present in the mouth. They usually do not cause an infection unless an abscess (pocket of pus) containing other bacteria such as streptococcus are present. Once Fusobacterium necrophorum multiplies in the abscess, it can then travel from the abscess to the internal jugular vein and cause an infected clot. Pieces of clot can then break off and travel to the lungs (septic emboli) resulting in serious infection and pneumonia. The disease happens most often in young, healthy adults.

Symptoms

Symptoms vary depending on the severity of disease and the organ systems involved. Usually, symptoms start with fever, sore throat, fatigue and swollen lymph nodes. After the infection has spread, symptoms may include chest pain, shortness of breath, cough, joint pain, muscle pain, jaw pain and jaundice (yellow skin color). Other symptoms may include headache, nausea/vomiting, diarrhea and facial nerve paralysis.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical will be performed. Blood tests and imaging tests such as a CT or MRI scan are often required to make the diagnosis.

Tests:
Blood culture, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Magnetic resonance imaging (MRI), X-ray

Specialists:
General Surgery, Internal Medicine, Vascular Surgery, Infectious Disease Medicine

Treatment

Treatment requires intravenous (IV) antibiotics and usually a few days in the hospital. The abscesses caused by the disease require surgical drainage if they are unresponsive to medical treatment. Blood thinners may also be used to help prevent further clot formation.