Abstract
Lemierre's syndrome is a potentially fatal disease that usually presents with oropharyngeal infection, followed by sepsis, thrombosis of the internal jugular vein and septic emboli. Most cases are caused by the Gram-negative, anaerobic Fusobacterium necrophorum. We present two patients with an atypical presentation of Lemierre's syndrome and a review. These cases illustrate that a positive blood culture for F. necrophorum, even without the presence of clinical symptoms pointing towards thrombosis of the internal jugular vein, justifies further radiological testing for thrombophlebitis of the internal jugular vein.
MeSH terms
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Acenocoumarol / therapeutic use
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Anti-Bacterial Agents / therapeutic use
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Anticoagulants / therapeutic use
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Bacteremia / complications
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Bacteremia / microbiology
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Deglutition Disorders / etiology
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Diarrhea / etiology
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Fusobacterium Infections / blood
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Fusobacterium Infections / complications
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Fusobacterium Infections / diagnosis*
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Fusobacterium Infections / drug therapy
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Fusobacterium Infections / microbiology
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Fusobacterium necrophorum / isolation & purification*
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Humans
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Jugular Veins* / diagnostic imaging
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Male
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Middle Aged
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Nadroparin / therapeutic use
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Penicillins / therapeutic use
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Pharyngitis / blood
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Pharyngitis / complications
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Pharyngitis / diagnosis*
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Pharyngitis / microbiology
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Pneumonia, Bacterial / etiology
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Syndrome
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Thrombophlebitis / diagnostic imaging
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Thrombophlebitis / drug therapy
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Thrombophlebitis / etiology*
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Ultrasonography
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Young Adult
Substances
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Anti-Bacterial Agents
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Anticoagulants
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Nadroparin
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Penicillins
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Acenocoumarol