Lemierre’s syndrome: a life-threatening sore throat
The present case has been reported in BMJ.

A 25-year-old previously healthy man presented to the emergency department with a 1-day history of dyspnoea, following a sore throat in the previous week. Physical examination revealed acute exudative tonsillitis and right-sided diminished breath sounds.

The laboratory analysis revealed a significantly elevated C reactive protein level of 30.67 mg/dL. A CT scan with contrast revealed a thrombophlebitis of the left internal jugular vein, a right-sided empyema and bilateral septic pulmonary emboli.

Gram staining of the purulent pleural fluid showed Gram-negative rods with abundant polymorphonuclear leukocytes. After the treatment with intravenous antibiotics and oral anticoagulation therapy at the intensive-care unit, the patient gradually recovered. Consequently, both blood and pleural fluid culture results were positive for Fusobacterium nucleatum, and Lemierre’s syndrome was diagnosed.

Learning points
• Lemierre’s syndrome should be considered as a differential diagnosis in young patients with a sore throat.

• It is important to consider further examination such as a contrast enhanced CT scan which includes the neck if Lemierre’s syndrome is suspected.

Read more here: http://casereports.bmj.com/content/2018/bcr-2018-227907.full
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