A 22-year-old man develops high fever, rigors, and pleuritic chest pain ten days after a severe left-sided sore throat treated incompletely. CT neck shows thrombus filling the left internal jugular vein, and chest imaging shows multiple cavitating lung nodules. Blood cultures grow Fusobacterium necrophorum. The diagnosis is:

• A Lemierre syndrome ✓
• B Grisel syndrome
• C Ludwig angina
• D Trotter syndrome

Explanation

Lemierre syndrome is septic thrombophlebitis of the internal jugular vein arising from an oropharyngeal infection, classically caused by Fusobacterium necrophorum, with septic pulmonary emboli producing cavitating lesions. It is called the forgotten disease because it follows seemingly trivial pharyngitis. Grisel syndrome is atlantoaxial subluxation, Ludwig angina is submandibular cellulitis, and Trotter triad describes unilateral deafness with neuralgia and immobility of the soft palate.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.