Lemierre’s syndrome: three cases and a review

  • Hans Dool
  • Robin Soetekouw
  • Marieke van Zanten
  • Edward Grooters


Postanginal sepsis, also called Lemierre’s syndrome, is a rare but acute medical condition complicating oropharyngeal infection. The pathogenesis consists of the development of internal jugular vein septic thrombophlebitis leading to metastatic infections in the lung and other sites. The causative microorganism is most often Fusobacterium necrophorum. We present three patients with Lemierre’s syndrome who presented to the Leiden University Medical Center and give a review of the literature.


Lemierre’s syndrome Oropharyngeal infection  Fusobacterium necrophorum 


  1. 1.
    Courmont P, Cade A (1900) Sur une septico-pyohemie de l’homme simulant la peste et causee par un streptobacille anaerobie. Arch Med Exp Anat Pathol:4Google Scholar
  2. 2.
    Lemierre A (1936) On certain septicaemias due to anaerobic organisms. Lancet 230:701–703CrossRefGoogle Scholar
  3. 3.
    Sinave CP, Hardy GL, Fardy PW (1989) The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (Baltimore) 68:85–94Google Scholar
  4. 4.
    Hagelskjaer LH, Prag J, Malczynski J, Kristensen JH (1989) Incidence and clinical epidemiology of necrobacillosis, including Lemierre’s syndrome, in Denmark 1990–1995. Eur J Clin Microbiol Infect Dis 17:561–565Google Scholar
  5. 5.
    Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ (2002) The evolution of Lemierre syndrome: report of two cases and review of the literature. Medicine (Baltimore) 81:458–465Google Scholar
  6. 6.
    Hagelskjaer Kristensen L, Prag J (2000) Human necrobacillosis, with emphasis on Lemierre’s syndrome. Clin Infect Dis 31:524–532CrossRefPubMedGoogle Scholar
  7. 7.
    Busch N, Mertens PR, Schonfelder T, Nguyen H, Marschall HU, Kierdorf H, Haase G, Urhahn R, Sieberth HG, Matern S (1996) Dtsch Med Wochenschr 121:94–98PubMedGoogle Scholar
  8. 8.
    Dagan R, Powell KR (1987) Postanginal sepsis following infectious mononucleosis. Arch Intern Med 147:1581–1583CrossRefPubMedGoogle Scholar
  9. 9.
    Nguyen-Dinh KV, Marsot-Dupuch K, Portier F, Lamblin B, Lasjaunias P (2002) Lemierre syndrome: usefulness of CT in detection of extensive occult thrombophlebitis. J Neuroradiol 29:132–135PubMedGoogle Scholar
  10. 10.
    Mathieu D, Neviere R, Teillon C, Chagnon JL, Lebleu N, Wattel F (1995) Cervical necrotizing fasciitis: clinical manifestations and management. Clin Infect Dis 21:51–56PubMedGoogle Scholar
  11. 11.
    Aimoni C, Cilione AR, Grandi E, Lombardi L, Merlo R, Pastore A (1999) Cervical necrotizing fasciitis. Eur Arch Otorhinolaryngol 256:510–513CrossRefPubMedGoogle Scholar
  12. 12.
    Skitareliç N, Mladina R, Moroviç M, Skitareliç N (2003) Cervical necrotizing fasciitis: sources and outcomes. Infection 31:39–44CrossRefPubMedGoogle Scholar
  13. 13.
    Williams A, Nagy M, Wingate J, Bailey L, Wax M (1998) Lemierre syndrome: a complication of acute pharyngitis. Int J Pediatr Otorhinolaryngol 45:51–57CrossRefPubMedGoogle Scholar
  14. 14.
    Brook I (2003) Microbiology and management of deep facial infections and Lemierre syndrome. ORL J Otorhinolaryngol Relat Spec 65:117-120PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Hans Dool
    • 1
  • Robin Soetekouw
    • 2
  • Marieke van Zanten
    • 1
  • Edward Grooters
    • 1
    • 3
  1. 1.Department of Otolaryngology and Head and Neck SurgeryLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of Infectious DiseasesLeiden University Medical CenterLeidenThe Netherlands
  3. 3.Department of Otorhinolaryngology and Head and Neck SurgerySaint Lucas Andreas HospitalAmsterdamThe Netherlands

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