Lemierre Syndrome: A Forgotten Disease, Complicated by Nocardial Necrotizing Fascitis and Pyomyositis of Right Calf

Abstract

Once coined the “Forgotten Disease,” Lemierre’s syndrome also known as human necrobacillosis is a rare condition that results from oropharyngeal infection with an obligate anaerobic gram-negative bacterium Fusobacterium necrophorum characterized by septic thrombophlebitis of the internal jugular vein, high fevers, and metastatic septic emboli. Necrobacillosis is the English term describing the necrotic abscesses associated fusobacterium sepsis. Most cases of F. necrophorum occur in association with an antecedent pharyngitis or head/neck infection; We describe an unusual case of necrobacillosis later complicated by lower extremity nocardial pyomyositis and necrotizing fasciitis in a 9-year-old otherwise healthy female child with a history of a preceding pharyngotonsillitis which required incision and drainage with surgical washout in addition to long term systemic broad antibiotics.