Case of the Month March, 2011, Page 4

Answer: C. Lemierre Syndrome

Case Findings

• Neck CT – Right peritonsillar fluid collection with enhancing rim consistent with abscess. Additionally, septic thrombophlebitis of right internal jugular vein.
• Chest CT – Multiple pulmonary nodules bilaterally some of which show cavitation. Given neck findings, septic emboli are most likely etiology.

Lemierre Syndrome

• Presentation: Fever and pharyngitis develop first followed by cough, chest pain, and shortness of breath once pulmonary findings develop.
• Treatment: Cultures followed by surgical drainage of abscess and long course antibiotic therapy depending of sensitivities. Supportive therapy.