Lemierre's Syndrome and Fusobacterium necrophorum Infections

Lemierre’s syndrome is a rare but potentially life-threatening condition that arises from an initial oropharyngeal infection and progresses to septic thrombophlebitis of the internal jugular vein. Fusobacterium necrophorum, an anaerobic Gram-negative bacillus, is the principal pathogen implicated in this syndrome, though other anaerobes and streptococci may contribute. The typical clinical presentation includes sore throat, high fever and lateral neck pain, followed by bacteraemia and metastatic abscesses, frequently affecting the lungs. Early antibiotic therapy has significantly reduced mortality, but delayed recognition can lead to systemic complications such as septic emboli, hepatic abscesses and deep-seated thromboses. Advances in imaging modalities, including contrast-enhanced ultrasound and MRI, have improved detection of jugular vein thrombosis. The organism’s virulence is linked to leukotoxin and haemagglutinin factors that facilitate endothelial invasion and clot formation. Epidemiological evidence suggests a resurgence of Lemierre’s syndrome in adolescents and young adults, possibly reflecting changing antimicrobial prescribing patterns. Current research aims to refine diagnostic pathways, assess the role of anticoagulation and elucidate host–pathogen interactions. Heightened clinical awareness and incorporation of molecular diagnostics are essential to ensure prompt, targeted interventions and improve patient outcomes globally.

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Lemierre's Syndrome and Fusobacterium necrophorum Infections publication trend

The graph below shows the total number of articles in lemierre's syndrome and fusobacterium necrophorum infections across all publications each year (not limited to Nature Index journals).

Technical terms

Lemierre’s syndrome: A condition marked by septic thrombophlebitis of the internal jugular vein following oropharyngeal infection, often leading to metastatic abscesses.

Fusobacterium necrophorum: A Gram-negative anaerobic bacterium implicated in Lemierre’s syndrome and other invasive infections.

Thrombophlebitis: Inflammation of a vein wall accompanied by clot formation.

Septic emboli: Infectious particles that travel through the bloodstream from a primary focus of infection to distant sites.

Metagenomic next-generation sequencing (mNGS): A culture-independent method for rapid identification of pathogens by sequencing all genetic material in a sample.

References

1. The impact of social restrictions on the incidence and microbiology of peritonsillar abscess: a retrospective cohort study. Clinical Microbiology and Infection (2023).
2. Case report: Metagenomics next-generation sequencing in the diagnosis of septic shock due to Fusobacterium necrophorum in a 6-year-old child. Frontiers in Cellular and Infection Microbiology (2024).
3. A case report of liver abscesses caused by Fusobacterium necrophorum in immunocompetent patient and review of the literature. Heliyon (2023).