Lemierre's syndrome is a rare complication following an acute oropharyngeal
infection. The aetiological agent is typically anaerobic bacteria of the genus Fusobacterium. The syndrome is characterised by a primary oropharyngeal
infection followed by metastatic spread and suppurative
thrombophlebitis of the internal jugular vein. If left untreated,
Lemierre's syndrome carries a mortality rate of over 90%. Whilst relatively common in the preantibiotic era, the number of cases of
Lemierre's syndrome subsequently declined with the introduction of
antibiotics. With the increase of antibiotic resistance and a greater reluctance to prescribe
antibiotics for minor conditions such as
tonsillitis, there are now concerns developing about the reemergence of the condition. This increasing prevalence in the face of an unfamiliarity of clinicians with the classical features of this "forgotten disease" may result in the misdiagnosis or delay in diagnosis of this potentially fatal illness. This case report illustrates the delay in diagnosis of probable
Lemierre's syndrome in a 17-year-old female, its diagnosis, and successful treatment which included the use of anticoagulation
therapy. Whilst there was a positive outcome, the case highlights the need for a suspicion of this rare condition when presented with distinctive signs and symptoms.