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Lemierre syndrome — SCE Acute Medicine MCQ

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HardSepsis and Infectious EmergenciesLemierre syndromeSCE Acute Medicine

A 23-year-old man is assessed on the acute medical unit. He has recent tonsillitis, rigors, neck pain along the sternocleidomastoid and pleuritic chest pain. CT shows internal jugular vein thrombosis with septic pulmonary emboli. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: C — Lemierre syndrome

Lemierre syndrome is the best answer because post-anginal sepsis with internal jugular thrombosis and septic emboli is characteristic of Lemierre syndrome. Adrenal crisis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Fusobacterium necrophorum is a classic pathogen.

Reference: ENT UK; infectious diseases guidance