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Introduction: Lemierre syndrome (LS) is considered as a forgotten disease since the beginning of Penicillin. The lack of use of beta-lactamase inhibitors antibiotics together with the increase in the use of macrolids or second-generation and third-generation cephalosporins for oropharyngeal processes has led to an increasing incidence. We propose to review all LS cases seen in an Emergency Department over the last 5 years., Methods: Retrospective study of patients diagnosed as LS in the Emergency Department of Hospital general universitario Gregorio Marañón from 2004 to the present. Descriptive analysis of age, gender, clinical features, laboratory and radiological results, management and outcome., Results: We had 6 patients with LS. 5 males. Median age: 25 years old. All with sore throat and pulmonary embolisms. 2 patients with negative blood cultures. 1 patient was admitted into ICU because of severe sepsis. One of the 6 developed acute renal failure, another one hemoptysis, and another a hydropneumothorax which was drained. All the patients were managed with antibiotics against anaerobes, carbapenems in 3 cases. Two patients did not receive anticoagulants, with no complications recorded. There were no deaths., Conclusion: LS still has a high morbidity, therefore it must be on mind in young people with febrile pharyngeal symptoms in order to start specific treatment as soon as possible to decrease complications. Carbapenems appears to be a good therapeutic choice., (Copyright © 2009 Elsevier España, S.L. All rights reserved.)

Lemierre's syndrome or postanginal septicaemia is described in the literature as an unusual complication of oropharyngeal infection. In most cases the syndrome is caused by Fusobacterium necrophorum. This disease usually occurs in young healthy individuals with an oropharyngeal infection, implying high fever, cervical tumefaction, and cervical pain, frequently associated with septic lung embolization. This case report is an unusual variant of this disease in a 12-year-old patient whose site of primary infection was the middle ear.

Nowadays due to the use of antibiotics the occurrence of a general complication of tonsillitis is extremely rare. Lemierre in 1936 throroughly described one of these events. We introduce a case of postanginal septicaemia detected in a previous healthy young woman. We also undertake a review of Lemierre's syndrome cases published within the last seven years in the English and Spanish literature, giving special attention to diagnostical methods and therapeutical strategies.

Cavernous sinus thrombophlebitis syndrome is uncommon nowadays. Despite the wide range of antimicrobial agents it carries a high mortality. The disease frequently arises from infection of face, mouth, nose and paranasal sinuses, reaching the cavernous sinus by venous spread. Involvement of adjacent anatomic structures accounts for most of the clinical findings. Meningeal involvement, bilateral orbital edema and ocular cranial nerves palsy are very helpful in the differential diagnosis. Streptococcus spp., Staphylococcus spp., Haemophilus influenzae and anaerobic organisms are considered to be the most frequent etiological agents. In the present paper we report a case of cavernous sinus thrombophlebitis following left side polysinusitis. The patient presented with the main clinical features of the syndrome along with Streptococcus equisimilis and Fusobacterium necrophorum bacteremia. Urgent surgery of infected sinuses and appropriate antibiotic therapy led to a favorable outcome. The patient made and excellent progress and was discharged completely recovered two weeks after admission.

The paper deals with a thrombophlebitis of the internal jugular vein, coming after a Plaut-Vincent's angina, associated to septic embolism of the lung. The syndrome was first described by Lemierre, in 1936. Together with a survey of the cases reported in the last ten years is made.