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Lemierre syndrome – a forgotten complication of acute tonsillitis

Published online by Cambridge University Press:  29 June 2007

C. B. Koay*
Affiliation:
Department of Otolaryngology, The Royal Berkshire Hospital, Reading.
T. Heyworth
Affiliation:
Department of Otolaryngology, The Royal Berkshire Hospital, Reading.
P. Burden
Affiliation:
Department of Microbiology, The Royal Berkshire Hospital, Reading.
*
Mr C. B. Koay, Department of Otolaryngology, Radcliffe Infirmary, Woodstock Road, Oxford OXZ 6HE.

Abstract

Lemierre syndrome, also known as postanginal sepsis, is an illness characterized by the development of a fusobacterial septicaemia with multiple metastatic foci following an attack of acute tonsillitis. It typically affects previously healthy adolescents and young adults who, following an attack of sore throat, become acutely ill with hyperpyrexia, rigors and multiple metastatic abscesses. The clinical picture tends to vary widely because of the possible involvement of a number of body systems and organs in the disease process. This serious complication of oropharyngeal sepsis had a mortality rate in excess of 90 percent in the pre-antibiotic era. Although now rarely seen and often forgotten, it remains a potentially life-threatening condition. We present four cases of post-tonsillitis fusobacterial septicaemia to illustrate the variability of the clinical presentation and stormy clinical course frequently associated with this rare syndrome.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1995

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