Information on Lemierre's Syndrome

Lemierre's Syndrome also known as necrobacillosisContrast computed tomography of the neck
or post-anginal sepsis. It is caused by theprovides the definitive diagnosis, showing
bacterium Fusobacterium necrophorum, anddistended veins with enhancing walls, intraluminal
occasionally by other members of the genusfilling defects, and swelling of contiguous soft
fusobacterium. Fusobacterium necrophorum is thetissues. A treatment involves intravenous antibiotic
most common pathogen isolated from thetherapy and drainage of septic foci. 
patients. The interval between the oropharyngealFusobacterium necrophorum is generally highly
infection and the onset of the septicaemia issusceptible to Beta-lactam antibiotics,
usually short. Deep in the abscess, anaerobicmetronidazole, clindamycin and third generation
bacteria like Fusobacterium necrophorum cancephalosporins while the other fusobacteria have
flourish. Fusobacterium necrophorum organism isvarying degrees of resistance to beta-lactams
found in the intestines of many species as part ofand clindamycin. The role of anticoagulation is
the normal flora. It survives well in wet soil thatcontroversial. Ligation or excision of the internal
has high manure content.jugular vein may be needed in some cases.
Other bacteria are frequently linked with theSurgical drainage of purulent collections may,
disease, swollen cervical lymph nodes andhowever, be required. Amputation of a toe may
septicemia (infection of the blood),be required in severe cases of foot rot where
arcanobacterium pyogenes being the mostthere is bone and joint involvement. Prolonged
common. Lemierre's Syndrome is an extremelytherapy is recommended because of the
rare disease which has tentatively been linked asendovascular nature of the infection. Ligation or
a having tongue piercing as a potential trigger.excision of the internal jugular vein is frequently
Lemierre's syndrome generally occurs in healthyrequired. As with most diseases, prevention is
adolescents and young adults. The infection usuallymuch more rewarding than treatment. Good
begins with a sore throat, followed by fever,general hygiene should be practiced with attention
septicemia, thrombosis, and metastatic abscesses.paid to control of excessive fecal contamination
Other symptoms of Lemierre's syndrome neckof paddocks, holding and handling facilities, and
tenderness or swelling develops.feeding equipment.