Lemierre’s syndrome

Also known as Lemierre’s disease and postanginal septicemia, Lemierre’s syndrome is a very rare disease where a throat infection caused by the bacterium Fusobacterium necrophorum leads to secondary infection and blood clot formation in the internal jugular vein.

Infected blood clots from the jugular veins travel through the bloodstream and cause pockets of infection or abscesses in other areas, such as the lungs, joints, liver, and kidneys. 

It is not contagious and is uncommon nowadays due to effective antibiotics. Although rare, Lemierre's syndrome is potentially deadly. However, with early diagnosis and treatment, the prognosis is good. 

Although Lemierre’s syndrome can develop in people of any age, it usually affects young children, teenagers and young adults. 

What are its symptoms?

Symptoms of Lemierre’s syndrome vary but usually start with a sore throat, fever and general weakness throughout the body. 

After infection starts to set in, symptoms worsen and include:

  • High fever
  • Rigors (chills and shivering)
  • Swollen lymph nodes in the neck 
  • Joint pain

Complications can lead to:

How is it diagnosed? 

A typical Lemierre’s syndrome diagnosis involves your doctor reviewing your symptoms, taking imaging scans of the neck and analysing blood test results.  

CT (computerised tomography) scans and an ultrasound of the neck may reveal inflammation of the pharynx and blood clotting in the jugular vein. If infection has spread to the lungs or lymph nodes, imaging tests can be used to gauge the damage.

Lemierre’s syndrome may also be diagnosed through blood tests that identify the bacteria causing the symptoms.

What are your treatment options? 

Let untreated, Lemierre’s syndrome can be lethal, so it’s essential to get treated as soon as possible. There is no cure for Lemierre’s syndrome.

Treatment includes antibiotics to kill the bacteria causing the illness. The antibiotics, usually given intravenously, must be delivered for longer than usual — typically for two to six weeks.

In some cases, blood thinners may also be prescribed to stop more blood clots from forming.

In severe cases of Lemierre’s syndrome, surgery may be needed to drain pus from abscesses in the throat, neck, or other organs.

In rare cases, surgery may be needed to remove the infected blood clots from the jugular veins, or to tie off the jugular veins to prevent blood clots that carry the bacteria from travelling to other parts of the body.

Can it be prevented? 

Early diagnosis and antibiotic treatment may prevent complete development of Lemierre’s syndrome. The key to survival is fast recognition of the disease, immediate use of antibiotics and drainage of abscesses. Even with prompt appropriate therapy, the mortality rate is reportedly 4 to 12 percent.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016