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Lemierre Syndrome — SCE Infectious Diseases MCQ

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HardRespiratory InfectionLemierre SyndromeSCE Infectious Diseases

A 24-year-old with tonsillitis develops Fusobacterium necrophorum bacteraemia, internal-jugular-vein thrombosis and multiple peripheral pulmonary nodules. Which diagnosis best unifies the findings?

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Correct answer: D — Lemierre syndrome with internal-jugular thrombophlebitis and septic pulmonary emboli

The triad of recent oropharyngeal infection, F. necrophorum bacteraemia and septic thrombophlebitis of the internal jugular vein with pulmonary embolic lesions is Lemierre syndrome. Source control, prolonged active antimicrobial therapy and assessment for metastatic complications are required; the alternatives do not explain the jugular focus and characteristic organism together.

Reference: Riordan: Human infection with Fusobacterium necrophorum, with a focus on Lemierre syndrome: https://pmc.ncbi.nlm.nih.gov/articles/PMC2176048/; UKHSA: Clinical and microbiological features of Fusobacterium species bacteraemia: https://researchportal.ukhsa.gov.uk/en/publications/clinical-and-microbiological-features-of-fusobacterium-species-ba/