Lemierre’s syndrome – case report

Abstract

Introduction: Lemierre’s syndrome or Lemierre’s disease is sepsis caused by tonsillitis. This is a rare disease that occurs during or after pharyngitis, connected with inflammation of the internal jugular vein and subsequent embolic abscesses in the lungs or viscera. It is most common in teenagers and young adults. The incidence of Lemierre’s syndrome is unknown but it is estimated at 1–2.5 cases per million people per year. The most common pathogen responsible for the disease is Fusobacterium necrophorum – from the name of this bacterium, the syndrome is also called necrobacillosis. Before the era of antibiotics, which began in the 1940s with the introduction of penicillin, Lemierre’s syndrome was more common and usually resulted in death after a few weeks. Over time, it became a „forgotten disease”, but nowadays, with the reduction of antibiotic therapy in common upper respiratory tract infections in young adults, the incidence of this syndrome is increasing again. Case report: In this study, the authors present the case of a 44-year-old man who was hospitalized due to life-threatening complications resulting from pharyngitis that had not been treated for about a week. Despite prompt treatment, subsequent complications could not be avoided. Ultimately the patient was saved. Conclusions: The occurrence of Lemierre’s syndrome is associated with a mortality rate of approximately 5–18%, but without proper diagnosis, the mortality rate is much higher. Although this disease is rare, it is worth remembering it, especially in young adults after a throat infection, with neck pain and pulmonary symptoms (abscesses, infiltrates in the lung parenchyma, pleural effusion).