Lemierre's Syndrome - Signs and Symptoms

Signs and Symptoms

The symptoms vary, but usually start with a sore throat, fever, and general body weakness. These are followed by extreme lethargy, spiked fevers, rigors, swollen cervical lymph nodes and a swollen, tender or painful neck. Often there is abdominal pain, diarrhea, nausea and vomiting during this phase. These symptoms usually occur several days to 2 weeks after the initial symptoms.

Symptoms of pulmonary involvement can be shortness of breath, cough and painful breathing (pleuritic chest pain). Rarely there is hemoptysis. Painful or inflamed joints (arthralgia or arthritis, respectively) exist when the joints are involved.

Septic shock can occur which presents as hypotension, tachycardia, oliguria and tachypnea. In cases with meningitis - nuchal rigidity, headache and photophobia occur.

Hepatomegaly and splenomegaly (enlarged liver and spleen, respectively) can be found, but are not always associated with hepatic or splenic abscesses.

Other signs and symptoms that may occur:

• Headache (not related to meningitis)
• Muscle pain
• Jaundice
• Trismus
• Crepitations are sometimes heard over the lungs
• Pericardial friction rubs as a sign of pericarditis (rare)
• Cranial nerve paralysis and Horner's syndrome (both rare)