Lemierre's syndrome due to Fusobacterium necrophorum

Lancet Infect Dis. 2012 Oct;12(10):808-15. doi: 10.1016/S1473-3099(12)70089-0. Epub 2012 May 25.


We present a case of a patient with Lemierre's syndrome caused by Fusobacterium necrophorum who developed a right frontal lobe brain abscess. We summarise the epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, complications, therapy, and outcomes of Lemierre's syndrome. F necrophorum is most commonly associated with Lemierre's syndrome: a septic thrombophlebitis of the internal jugular vein. Patients usually present with an exudative tonsillitis, sore throat, dysphagia, and unilateral neck pain. Diagnosis of septic thrombophlebitis is best confirmed by obtaining a CT scan of the neck with contrast. Complications of the disease include bacteraemia with septic abscesses to the lungs, joints, liver, peritoneum, kidneys, and brain. Treatment should include a prolonged course of intravenous beta-lactam antibiotic plus metronidazole.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Brain Abscess / diagnosis
  • Brain Abscess / drug therapy*
  • Brain Abscess / microbiology
  • Fusobacterium necrophorum*
  • Humans
  • Lemierre Syndrome / complications
  • Lemierre Syndrome / drug therapy*
  • Lemierre Syndrome / microbiology
  • Magnetic Resonance Imaging
  • Male
  • Pleural Effusion / complications


  • Anti-Bacterial Agents