Lemierre syndrome caused by Arcanobacterium haemolyticum
A54-year-old male smoker was admitted to our hospital after undergoing the drainage of a left peritonsillar abscess.Ten days prior to admission (day 1),he complained of a "scratchy" throat with a fever of 38.5°C.He had an enlarged left tonsil with prominent exudate;white blood cell count (WCC) 8.8×109/L;platelet count (Pit) 103 × 109/L;chest X-ray was normal in a medical clinic.Then the patient received an intravenous injection of 4 million units of penicillin G every 6 hours and 500 mg of oral azithromycin once daily.But his condition worsened with a temperature of 41°C and laryngoscopy confirmed a marked left-sided peritonsillar abscess which was drained.On day 10,the patient was transferred to our hospital after developing persistent fever,rigors,left-sided neck pain,pain on swallowing and purulent bloody sputum.On examination,his temperature was 39.6°C,pulse 95 beats/min;respiratory rate 25 breaths/min and blood pressure 110/80 mmHg (1 mmHg=0.133 kPa).The left side of his neck was swollen and tender,anterior to the sternocleidomastoid muscle.
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