DOI: 10.12890/2025_005063
Lemierre’s syndrome: an unlikely diagnosis in a patient presenting with diarrhoea and vomiting, or maybe not?
Authors
adam.young.1985@gmail.com
Keywords
Lemierre’s syndrome, fusobacterium, gastrointestinal, diarrhoeaAbstract
Lemierre’s syndrome is an infectious thrombophlebitis of the internal jugular vein (IJV) where the commonest causative agent is a Fusobacterium from a tonsillar or peritonsillar abscess. This is a case presentation of a patient whose primary complaint was diarrhoea. The blood cultures of this patient grew a Fusobacterium necrophorum which prompted imaging. The imaging demonstrated a right peritonsillar abscess and IJV thrombosis with septic emboli in the lungs. Key points highlighted are: 1) blood cultures remain a key investigation in making a diagnosis in the septic patient; 2) abdominal symptoms can be part of Lemierre’s syndrome; 3) abdominal symptoms (abdominal pain, vomiting and diarrhoea) have been characterised as the third, fourth and fifth most common feature after fever and dyspnoea. This case is presented because it shows how Lemierre’s syndrome can present with abdominal features, and this may be incongruent with clinicians’ understanding and teaching.
References
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