Work

Lemierre’s syndrome: an unlikely diagnosis in a patient presenting with diarrhoea and vomiting, or maybe not?

Year: 2025

Type: article

Abstract: 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.

Source: European Journal of Case Reports in Internal Medicine

DOI: 10.12890/2025_005063

Authors: Giorgos Papaleontiou, Adam Young

Institution: Health Education England

Language: English

Topic: Otolaryngology and Infectious Diseases

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $323