LEMIERRE-SYNDROME - A COMPLICATION OF ACUTE PHARYNGITIS

Lemierre syndrome, otherwise known as postanginal sepsis or necrobacil losis, is an illness that originates as an acute pharyngitis or tonsil litis which progresses to sepsis, usually fusobacterial, due to suppur ative thrombophlebitis of the internal jugular vein. Septic thromboemb oli then seed various organs, resulting in multiple organ system patho logy, most commonly affecting pulmonary and hepatic systems and joints . Although rare in the age of antibiotics, this disease typically affe cts previously healthy adolescents with varied clinical manifestations depending upon organ system involvement (A. Lemierre, Lancet March (1 936) 701-703; J. Barker, H.T. Winer-Muram, S. Grey, Southern Med. J. 8 9 (1996) 1021-1023). Prompt diagnosis based on clinical presentation. radiologic findings, particularly CT scanning with contrast and a high index of suspicion, is necessary in order to institute often life sav ing therapy (J, Barker, H.T. Winer-Muram, S. Grey, Southern Med. J. 89 (1996) 1021-1023). We will present two cases of Lemierre syndrome, re view it's clinical presentation, anatomic considerations, particularly it's relationship to the parapharyngeal space, radiographic findings, potential life threatening complications and finally, a unique approa ch to therapy. (C) 1998 Elsevier Science ireland Ltd. All rights reser ved.