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Clinical Problem Solving: Radiology
May 2002

Diagnosis Radiology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(5):599. doi:

Lemierre syndrome, or postanginal sepsis, follows an episode of pharyngitis or tonsillitis. Alterations in the mucosal defense system allow infection of the oropharynx and lateral pharyngeal space, most often with F necrophorum. Infection leads to septic thrombi within the pharyngeal and peritonsillar veins, resulting in thrombosis of the internal jugular vein and metastatic abscesses.

In 1936, Lemierre1 described 20 cases involving previously healthy young patients who developed septicemia several days after tonsillar or peritonsillar infections, noting that the clinical findings of postanginal sepsis and internal jugular vein thrombosis constituted a characteristic syndrome. The illness was rapidly fatal in 18 of the 20 patients. Although antibiotic therapy has dramatically improved patient outcomes, Lemierre syndrome remains a serious illness, and patients still die of overwhelming sepsis despite treatment with antibiotics.

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