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Fusobacterium necrophorum sepsis after tonsillitis/pharyngitis
  1. Micheal Sheehan,
  2. Darren McLoughlin and
  3. Ronan O’Sullivan
  1. Emergency Department, Cork University Hospital Group, Cork, Ireland
  1. Correspondence to Professor Ronan O’Sullivan, rgosullivan{at}


Fusobacterium necrophorum is a rare infection most notable for causing Lemierre’s syndrome. This consists of a primary oropharyngeal infection and septic thrombophlebitis, and one or more metastatic focus. Prior to the widespread use of antibiotics, Lemierre’s syndrome commonly followed a rapidly progressing course, with a high mortality. We describe a case of a previously well 18-month-old boy who presented to the emergency department with a 3-week history of progressive, right-sided, painful neck swelling and systemic sepsis. He was initially treated conservatively with intravenous antibiotics, but ultimately required surgical drainage. Lemierre’s syndrome is a rare condition with increasing incidence which can have significant adverse outcomes including death. Early recognition and treatment are essential, but identifying Lemierre’s disease is challenging.

  • emergency medicine
  • general practice / family medicine
  • infectious diseases
  • exposures
  • otolaryngology / ent

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  • Contributors MS drafted the manuscript with proofreading and revisions made by DM and ROS. All authors approved the final version. They were involved in the conception of this case report. They agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.