Introduction
Lemierre’s syndrome (LS) is a rare disease which results from infective
thrombophlebitis of the internal jugular vein following an acute
oropharyngeal infection. Following decades of decline, the incidence of
LS has increased in recent years. Multiple septic pulmonary emboli are
common, but all organ systems can be involved. Although LS is most often
caused by Fusobacterium necrophorum , other pathogens have been
implicated. Persistent high fever and organ-specific signs and symptoms
result from the septic emboli. The diagnosis is often suspected
following growth of Fusobacterium from blood cultures and is
confirmed by head and neck imaging. Therapy includes organism-specific
antimicrobial treatment, drainage of abscesses, and anticoagulation.
Significant morbidity and mortality may occur if diagnosis and treatment
are delayed. Pediatric pulmonologists must be aware of this rare disease
and maintain a high index of suspicion in cases consistent with
Lemierre’s syndrome.