Lemierre's syndrome: A forgotten and re-emerging infection
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
53
Journal Issue
4
Pages
513-517
Date Issued
2020
Author(s)
Abstract
Lemierre's syndrome, also known as post-anginal septicemia or necrobacillosis, is characterized by bacteremia, internal jugular vein thrombophlebitis, and metastatic septic emboli secondary to acute pharyngeal infections. Modern physicians have “forgotten” this disease. The most common causative agent of Lemierre's syndrome is Fusobacterium necrophorum, followed by Fusobacterium nucleatum and anaerobic bacteria such as streptococci, staphylococci, and Klebsiella pneumoniae. The causative focus mostly originated from pharyngitis or tonsillitis, accounting for over 85% of the cases of Lemierre's syndrome. Pneumonia or pleural empyema is the most common metastatic infection in Lemierre's syndrome. Antimicrobial therapy should be prescribed for 3–6 weeks. The treatment regimens include metronidazole and β-lactam antibiotics. In recent years, the antibiotic stewardship program has resulted in decreased antibiotic prescription for upper respiratory tract infections. The incidence of Lemierre's syndrome has increased over the past decade. F. necrophorum is an underestimated cause of acute pharyngitis or tonsillitis. A high index of suspicion is required for the differential diagnosis of acute tonsillopharyngitis with persistent neck pain and septic syndrome. ? 2020
SDGs
Other Subjects
beta lactam antibiotic; metronidazole; antiinfective agent; antibiotic therapy; antimicrobial stewardship; clinical feature; Fusobacterium necrophorum; Fusobacterium nucleatum; human; Klebsiella pneumoniae; Lemierre syndrome; nonhuman; pathogenesis; pleura empyema; pneumonia; Review; Staphylococcus; Streptococcus; anaerobic bacterium; bacterium; classification; communicable disease; Lemierre syndrome; microbiology; pathogenicity; pharyngitis; sepsis; Anti-Bacterial Agents; Bacteria; Bacteria, Anaerobic; Communicable Diseases, Emerging; Fusobacterium necrophorum; Humans; Lemierre Syndrome; Pharyngitis; Sepsis
Type
review