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Rare disease
CASE REPORT
Lemierre’s syndrome: a rare cause of sepsis presenting with an absence of throat symptoms
  1. Thomas Whittle1,
  2. Natasha Amiraraghi1,
  3. Bappa Sarkar2
  1. 1Ear,Nose and Throat Surgery, NHS Ayrshire and Arran, Crosshouse Hospital, Ayr, UK
  2. 2Radiology, NHS Ayrshire and Arran, Crosshouse Hospital, Ayr, UK
  1. Correspondence to Dr Thomas Whittle, thomas.whittle.10{at}aberdeen.ac.uk

Summary

A 16-year-old boy presented to hospital with a 6-day history of diarrhoea, vomiting and abdominal pain. During his admission he was found to be hypotensive, tachycardic and persistently feverish. Blood cultures taken on admission isolated Fusobacterium necrophorum. CT scanning of his neck showed a non-occlusive thrombus of the right internal jugular vein and a small right parapharyngeal abscess. CT scans of the chest and abdomen revealed multiple pulmonary abscesses, bilateral pleural effusions and splenomegaly. Treatment consisted of an unfractionated heparin infusion and intravenous antibiotics. A right-sided intercostal drain was inserted for a complex right-sided empyema. He subsequently developed a left-sided pleural effusion which was treated with a video-assisted thoracoscopic surgery (VATS) pleurodesis procedure. His fever resolved after his VATS pleurodesis procedure 3 weeks after initial presentation. Clinically he made a slow recovery but now is improved after 6 weeks of intravenous antibiotics and was discharged home.

  • otolaryngology / ent
  • infectious diseases
  • respiratory medicine

https://doi.org/10.1136/bcr-2017-224151

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    Footnotes

    • Contributors TW: clinical development fellow involved in the case and writing of the report at main author. NA: cochlear clinical fellow involved in the case management and assisted with writing of case report. BS: consultant radiologist involved in interpretation of radiology and acquisition of figures for the case report.

    • 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.