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J Emerg Med. 2009 Aug;37(2):131-4. doi: 10.1016/j.jemermed.2007.07.066. Epub 2008 Feb 14.

Lemierre's syndrome: methicillin-resistant Staphylococcus aureus (MRSA) finds a new home.

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Department of Emergency Medicine, Emergency Medicine Residency Program, Orlando Regional Medical Center, Orlando, Florida 32806-2093, USA.


Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein, arising as a complication of an oropharyngeal infection. This thrombophlebitis frequently results in septic emboli to organs such as the lungs. The causative agent in most previously described cases is Fusobacterium necrophorum, an anaerobic Gram-negative organism. We present the case of an 8-year-old previously healthy girl who came to the Emergency Department with a 5-day history of left-sided neck pain and was subsequently diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) Lemierre's syndrome. MRSA has not previously been described in Lemierre's syndrome in the Emergency Medicine literature. The clinical presentation, findings, and management of the syndrome are discussed. Regardless of etiology, once the diagnosis of Lemierre's syndrome is made, long-term broad-spectrum intravenous therapy will be necessary.

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