Lemierre’s syndrome - septic thrombophlebitis of the internal jugular vein
Lemierre’s syndrome is an uncommon complication of pharyngitis usually caused by Fusobacterium necrophorum, an anaerobe, that leads to suppurative thrombophlebitis of the internal jugular vein and subsequent disseminated infection, often with septic pulmonary emboli.
It usually presents as a prolonged pharyngitis in a patient who is febrile, appears ill, has asymmetric anterior neck swelling, often pleuritic chest pain, shortness of breath, and often tachypnea with abnormal oxygen saturation. It is diagnosed with CT neck (and usually chest) with contrast. It’s treated with broad spectrum antibiotics that cover anaerobes, such as piperacillin-tazobactam or ampicillin-sulbactam, often in an ICU setting.