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Case report
Lemierre’s syndrome in an intravenous drug user
  1. Daniel Fernandez1,
  2. Mirza Ahmad1,
  3. Gary Decker2 and
  4. Mark M Aloysius1,3
  1. 1Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
  2. 2Department of Infectious Disease, Wilkes-Barre General Hospital, Wilkes-Barre, Pennsylvania, USA
  3. 3Department of Internal Medicine, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
  1. Correspondence to Dr Mark M Aloysius; vamedicalresident{at}


A 29-year-old Dominican man with a history of intravenous heroin use and hepatitis C presented with a 5-day history of fever, dyspnoea, haemoptysis, pleuritic chest pain, abdominal pain, haematochezia and haematemesis. Initial physical examination was significant for scleral icterus, generalised abdominal tenderness to palpation, melaena and blood-tinged sputum. Blood cultures grew Fusobacterium species. CT scan of the chest revealed multiple bilateral cavitary features in lung fields. At the same time, a neck ultrasound performed demonstrated thrombophlebitis in the right internal jugular vein, confirming the diagnosis of ‘Lemierre’s syndrome’. Treatment was with antibiotics and supportive care for 6 weeks.

  • pneumonia (infectious disease)
  • drugs misuse (including addiction)
  • drugs: infectious diseases
  • venous thromboembolism
  • medical management

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  • Contributors DF, MA, GD and MMA were involved in planning the manuscript, acquisition and reporting of the patient data. DF and MA were involved in drafting the manuscript. DF and MMA were involved in editing the manuscript and images. All authors reviewed the final version of the manuscript and have concurred on submission to the journal.

  • 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 for publication Obtained.

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