Ziad Sara, MD, FASN

Lemierre's syndrome is characterized by oropharyngeal infection, usually by Fusobacterium necrophorum, followed by septic thrombophlebitis of the internal jugular vein with embolization to the lungs and other organs. Since the introduction of antibiotics, Lemierre's syndrome has become relatively rare and is usually unsuspected until blood culture results are available. In the preantibiotic era, ligation of the internal jugular vein on the affected side to prevent septicemia was the only recognized treatment. Current therapy is a 4- to 6-week course of antibiotics, such as penicillin G, clindamycin, or metronidazole, directed against F necrophorum. The use of anticoagulation is still controversial.