From a sore throat to the intensive care unit: the Lemierre syndrome

[A parotitis as primary infection of Lemierre's syndrome]

Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum.

Jugularvenenthrombose als paraneoplastisches Syndrom

Thrombosis of the internal jugular vein is a rare form of deep vein thrombosis with potentially life threatening complications. We report on a 46-year-old male presenting with dysphagia and neck swelling. An extensive thrombosis of the internal jugular vein was found on ultrasound of the neck. An interdisciplinary workup revealed an occult gastric carcinoma. This case demonstrates that concomitant malignancies may contribute to a thrombosis of the internal jugular vein, which is then the primary symptom presented by the patient.