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.