Fusobacterium necrophorum Pharyngitis Complicated by Lemierre’s Syndrome

Abstract EN

We report the case of an 18-year-old woman who was referred to our outpatient clinic because of a 2-week history of sore throat, high fever, and neck tenderness unresponsive to a 7-day amoxicillin/clavulanic acid course.

Infectious mononucleosis was initially suspected, but an extremely high value of procalcitonin and clinical deterioration suggested a bacterial sepsis, prompting the patient admission to our internal medicine ward.

Blood cultures were positive for Fusobacterium necrophorum.

CT scan detected a parapharyngeal abscess, a right internal jugular vein thrombosis, and multiple bilateral lung abscesses, suggesting the diagnosis of Lemierre’s syndrome.

The patient was treated with a 2-week course of metronidazole and meropenem with a gradual clinical recovery.

She was thereafter discharged home with metronidazole and amoxicillin/clavulanic acid for 14 days and a 3-month course of enoxaparin, experiencing an uneventful recovery.

The present case highlights the importance of taking into consideration the Lemierre’s syndrome whenever a pharyngotonsillitis has a severe and unusual course.