It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia

We report a case of a syndrome first described by French bacteriologist André Lemierre nearly 100 years ago. A young woman presented with fever, chest pain and arthralgia. Admission investigations revealed thrombocytopenia, cavitating pneumonia and an internal jugular vein thrombus. Blood cultures w...

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Main Authors: Edmund Hugh Larkin, Ana Garcia-Mingo, Roopal Patel, Andrew Badacsonyi
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Clinical Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S1470211824054459
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author Edmund Hugh Larkin
Ana Garcia-Mingo
Roopal Patel
Andrew Badacsonyi
author_facet Edmund Hugh Larkin
Ana Garcia-Mingo
Roopal Patel
Andrew Badacsonyi
author_sort Edmund Hugh Larkin
collection DOAJ
description We report a case of a syndrome first described by French bacteriologist André Lemierre nearly 100 years ago. A young woman presented with fever, chest pain and arthralgia. Admission investigations revealed thrombocytopenia, cavitating pneumonia and an internal jugular vein thrombus. Blood cultures were positive for Fusobacterium necrophorum and Streptococcus constellatus. Respiratory failure developed within 48 h and was managed with high-flow nasal oxygen in a critical care setting. The investigation findings leading to diagnosis, as well as the antimicrobial and anticoagulation management strategies, are discussed. Lemierre's syndrome is rarely encountered by non-specialists, but a good outcome can be expected with prompt diagnosis and treatment.
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publishDate 2024-11-01
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spelling doaj-art-17f82db557ce44469fc862ccd761064b2025-08-20T02:49:05ZengElsevierClinical Medicine1470-21182024-11-0124610026010.1016/j.clinme.2024.100260It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopeniaEdmund Hugh Larkin0Ana Garcia-Mingo1Roopal Patel2Andrew Badacsonyi3Intensive Care Unit, Whittington Health Trust, London, United Kingdom; Corresponding author.Infectious Diseases and Microbiology, Whittington Health Trust, London, United KingdomRadiology, Whittington Health Trust, London, United KingdomIntensive Care Unit, Whittington Health Trust, London, United KingdomWe report a case of a syndrome first described by French bacteriologist André Lemierre nearly 100 years ago. A young woman presented with fever, chest pain and arthralgia. Admission investigations revealed thrombocytopenia, cavitating pneumonia and an internal jugular vein thrombus. Blood cultures were positive for Fusobacterium necrophorum and Streptococcus constellatus. Respiratory failure developed within 48 h and was managed with high-flow nasal oxygen in a critical care setting. The investigation findings leading to diagnosis, as well as the antimicrobial and anticoagulation management strategies, are discussed. Lemierre's syndrome is rarely encountered by non-specialists, but a good outcome can be expected with prompt diagnosis and treatment.http://www.sciencedirect.com/science/article/pii/S1470211824054459Lemierre's syndromeFusobacterium necrophorumThrombophlebitis of the internal jugular veinCavitating lung lesionsThrombocytopenia
spellingShingle Edmund Hugh Larkin
Ana Garcia-Mingo
Roopal Patel
Andrew Badacsonyi
It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
Clinical Medicine
Lemierre's syndrome
Fusobacterium necrophorum
Thrombophlebitis of the internal jugular vein
Cavitating lung lesions
Thrombocytopenia
title It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
title_full It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
title_fullStr It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
title_full_unstemmed It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
title_short It all started with a sore throat: Polymicrobial septicaemia, cavitating lung lesions and severe thrombocytopenia
title_sort it all started with a sore throat polymicrobial septicaemia cavitating lung lesions and severe thrombocytopenia
topic Lemierre's syndrome
Fusobacterium necrophorum
Thrombophlebitis of the internal jugular vein
Cavitating lung lesions
Thrombocytopenia
url http://www.sciencedirect.com/science/article/pii/S1470211824054459
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