Lemierre's Syndrome in Adolescent Children—Anaerobic Sepsis With Internal Jugular Vein Thrombophlebitis Following Pharyngitis
1 Department of Pediatrics, Division of Infectious Diseases, Rainbow Babies and Children's Hospital and Metrohealth Medical Center, Case Western Reserve University School of Medicine, Cleveland OH 44106
2 Department of Pediatrics, Division of Infectious Diseases, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106
Sepsis following pharyngitis, referred to as postanginal sepsis, was first described at the beginning of this century. However, it was not until 1936 that a distinctive syndrome of postanginal sepsis and internal jugular vein (IJV) septic thrombophlebitis was characterized in detail by Lemierre.1 His original description focused on previously healthy adolescents and young adults who developed septicemia several days after a tonsillar or peritonsillar infection. There was usually painful swelling of the glands below the maxillary angle and edema and tenderness on the lateral aspects of the neck parallel to the sternomastoid muscle, representing septic thrombophlebitis of the IJV. Distant metastatic abscesses from septic embolization were present most frequently in the lungs and pleura, but also occurred in the joints and soft tissues.
Submitted on September 2, 1994Accepted on December 1, 1994
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