Lemierre's Syndrome - Diagnosis

Diagnosis

Diagnosis and the imaging (and laboratory) studies to be ordered largely depend on the patient history, signs and symptoms. If a persistent sore throat, with the symptoms are found, physicians are cautioned to screen for Lemierre's syndrome.

Laboratory investigations reveal signs of a bacterial infection with elevated C-reactive protein, erythrocyte sedimentation rate and white blood cells (notably neutrophils). Platelet count can be low or high. Liver function tests and renal function tests are often abnormal.

Thrombosis of the internal jugular vein can be displayed with sonography. However, thrombi that have developed recently have low echogenicity and thus will not show up on ultrasound. A CT scan or an MRI scan is more sensitive in displaying the thrombus.

Chest X-ray and chest CT may show pleural effusion, nodules, infiltrates, abscesses and cavitations.

Bacterial cultures taken from the blood, joint aspirates or other sites can identify the causative agent of the disease.

Other illnesses that can be included in the differential diagnosis are:

• Q fever
• Tuberculosis
• Pneumonia