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A young previously healthy patient presented with sepsis and cavitating pneumonia. Campylobacter rectus was isolated from blood cultures and subsequent CT neck showed an internal jugular vein thrombosis. Treatment was with antibiotics, anticoagulation and supportive management. Lemierre's syndrome is an infectious thrombophlebitis of the internal jugular vein. Although a rare diagnosis since the use of penicillin for treatment of acute pharyngitis, it is being reported with increasing frequency. Usually associated with Fusobacterium spp, we believe that this is the first reported case of Lemierre's caused by C. rectus-an anaerobic member of the human oral cavity flora, usually associated with localised periodontal disease. The bacillus was isolated from blood during the acute presentation.

Original publication

DOI

10.1136/bcr-2018-226948

Type

Journal

BMJ case reports

Publication Date

28/11/2018

Volume

11

Addresses

Infectious Diseases, University College London Hospitals NHS Foundation Trust, London, UK.

Keywords

Jugular Veins, Humans, Campylobacter rectus, Sepsis, Pharyngitis, Pneumonia, Venous Thrombosis, Thrombophlebitis, Acute Disease, Penicillins, Anticoagulants, Anti-Bacterial Agents, Diagnosis, Differential, Tomography, X-Ray Computed, Treatment Outcome, Adult, Male, Lemierre Syndrome, Computed Tomography Angiography