User:Mr. Ibrahem/Lemierre syndrome

Lemierre syndrome is infectious thrombophlebitis of the internal jugular vein. Initial symptoms include fever, neck pain, and neck swelling. Generally the pain and swelling is one sided and occurs at the angle of the jaw. Later symptoms may include pneumonia, pleural empyema, sepsis, brain abscess, and septic emboli. Complications may include septic shock, disseminated intravascular coagulation, and end organ failure.

It most commonly occurs follow a throat infection due to the bacteria Fusobacterium necrophorum. Other bacteria that may be involved include Fusobacterium nucleatum, streptococci, staphylococci, and Klebsiella pneumoniae. The underlying mechanism involves spread of infection to the lateral pharyngeal space. Diagnosis is generally based on symptoms and ultrasound or CT scan; as culture results take around a week.

Treatment is generally with around two weeks of antibiotics by intravenous followed by up to another six weeks of antibiotics by mouth. Other measures include anticoagulation and surgery to drain any abscesses. With treatment, the risk of death is 5 to 18%. Before the availability of antibiotics, the risk of death was 90% over about 2 weeks.

Lemierre's syndrome occurs in 1 to 6 per million people per year. Young adults males are most commonly affected. In 1936, André Lemierre described 20 cases where throat infections was followed by sepsis.