[Lemierre's syndrome with splenic abscesses]

Dtsch Med Wochenschr. 1992 Oct 2;117(40):1513-7. doi: 10.1055/s-2008-1062472.
[Article in German]


A week after onset of a pharyngo-tonsillitis a previously healthy 23-year-old man developed high fever (41.4 degrees C), leukocytosis (12,200/microliters) with marked shift to the left, thrombocytopenia (86,000/microliters) and increased transaminases (GOT 83 U/l, GPT 113 U/l). Chest x-ray film suggested intrapulmonary abscesses with left-sided pleural effusion. The suspected diagnosis of "post-tonsillitis" septicaemia (Lemierre's syndrome) was confirmed by demonstrating anaerobic, fusiform, gram-negative bacteria (Fusobacterium nucleatum and necrophorum) in several blood cultures. Despite antibacterial treatment (amoxicillin/clavulanic acid, imipenem/cilastatin, clindamycin) he had recurrent pain referred to the kidney region and persisting fever. Repeated ultrasound and radiological examinations revealed new foci in the spleen, which were enlarging. Laparotomy with splenectomy performed on day 17 after the begin of treatment confirmed multiple splenic abscesses, but abscess pus and splenic tissue were sterile. After altogether 6 weeks of antibiotic treatment, finally with chloramphenicol, the patient was discharged in a good general state.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Abscess / diagnosis
  • Abscess / etiology*
  • Abscess / therapy
  • Adult
  • Bacteremia / diagnosis
  • Bacteremia / etiology*
  • Bacteremia / therapy
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Fusobacterium Infections / diagnosis
  • Fusobacterium Infections / etiology*
  • Fusobacterium Infections / therapy
  • Fusobacterium necrophorum*
  • Humans
  • Male
  • Pharyngitis / complications*
  • Pharyngitis / diagnosis
  • Pharyngitis / therapy
  • Splenectomy
  • Splenic Diseases / diagnosis
  • Splenic Diseases / etiology*
  • Splenic Diseases / therapy
  • Syndrome
  • Tonsillitis / complications*
  • Tonsillitis / diagnosis
  • Tonsillitis / therapy