Postgrad Med J 1999;75:141-144 ( March )

Review

Eponyms in medicine revisited

Lemierre's syndrome (necrobacillosis) Rafael Golpe, Belén Marín, Miguel Alonso

Respiratory Section, University Hospital Marqués de Valdecilla, Santander, Spain

Correspondence to: Rafael Golpe, General Pardiñas 6-4°, 15701 Santiago de Compostela, Spain

Accepted 2 November 1998

Lemierre's syndrome or postanginal septicaemia (necrobacillosis) is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. Fusobacterium necrophorum is the most common pathogen isolated from the patients. The interval between the oropharyngeal infection and the onset of the septicaemia is usually short. The most common sites of septic embolisms are the lungs and joints, and other locations can be affected. A high degree of clinical suspicion is needed to diagnose the syndrome. Computed tomography of the neck with contrast is the most useful study to detect internal jugular vein thrombosis. Treatment includes intravenous antibiotic therapy and drainage of septic foci. The role of anticoagulation is controversial. Ligation or excision of the internal jugular vein may be needed in some cases.


Keywords: Lemierre's syndrome; Fusobacterium necrophorum; necrobacillosis; septicaemia; oropharynx

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© 1999 by The Fellowship of Postgraduate Medicine
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