HET SYNDROOM VAN LEMIERRE: EEN GECOMPLICEERDE OROFARYNGEALE INFECTIETHE LEMIERRE SYNDROME: A COMPLICATED OROFARYNGEAL INFECTION

The Lemierre syndrome or 'necrobacillosis' is a post angina sepsis caused by an acute orofaryngeal infection with a secondary thrombofl ebitis of the internal jugular vein. There are often septic emboli in the lungs, although intestinal organs can also be affected. This syndrome is caused by the strictly anaerobic gram-negative pathogen Fusobacterium necrophorum, sometimes in combination with other pathogens. The patient typically presents with high fever, pain in the neck, malaise and dyspnoea one week after the start of an angina. Plain chest radiograph shows bilateral nodular infi ltrates, ultrasound reveals a thrombofl ebitis of the internal jugular vein. CT scan can be useful to confi rm the diagnosis and possible compli- cations. In the beginning there is often a transient hy- perbilirubinemia with toxic infl ammatory blood results. Under the correct antibiotic regime complete recovery can be obtained.