Not Just a Regular Sore Throat: Complications Leading to Lemierre Syndrome

Authors: Chancee Forestier, Rehana Hassan, Jideka Nwosu, Olivia Warren, Sarah Norman

American Medical Women’s Association, American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten

Abstract:

This case serves as a foundation to explore the complications, antibiotic usage and many other aspects in a rare condition called Lemierre Syndrome. Medicine is constantly evolving to promptly diagnose and treat patients to avoid complications such as this one. However, many complications are inevitable and require immediate attention. Lemierre syndrome results from the development of an acute oropharyngeal infection in young adults. The causative agent, Fusobacterium necrophorum, is a Gram-negative rod, which grows in anaerobic conditions and resides in the normal flora of the oropharynx. The condition presents when the bacteria navigate to the jugular vein and develops a clot within the vasculature. A complication that can arise is thrombophlebitis, which can further progress to cause septicemia and in extreme cases, death.

Although this syndrome is rare and typically seen in young adults, it is vital to diagnose and treat this infection in a timely manner. 

The patient presents as a healthy, 36-year-old father with a six-year-old son and a newborn baby. Prior to the incidence, the father and 6-year-old son had been prescribed Amoxicillin for exudative tonsillitis. Symptoms of sore throat and upper respiratory illness resided within a few days of antibiotic usage. However, the following 10-14 days, the patient succumbed to intermittent fever, chills and progressive throat pain. A follow up visit to the primary care physician was made and his vital signs and clinical presentation suggested admittance into the hospital. With the combination of physical exam, radiographic imaging, complete blood count and his previous history of treatment for exudative tonsillitis, findings were consistent with Lemierre Syndrome. Improvement was shown after 48 hours and the patient had a full recovery. The overall prognosis and management for this Syndrome, along with many others, has improved significantly with today’s antibiotic therapies. This case exemplifies modern medicine and by virtue, how innovative the medical field continues to become.

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