Pulmonary angiogram was normal. Thoracentesis yielded 1000 ml of bloody fluid, and a white count of 14,000. He was again discharged on intravenous clindamycin. Lemierre's disease consists of oropharyngeal symptoms, local septic thrombophlebities and multiple metastatic abscesses frequently involving the lungs and large joints caused by Fusobacterium Necrophorum. A high index of suspicion is necessary since antibiotics are effective.
Treatment includes prolonged antibiotics and surgical drainage.
While rare, this disease is still seen in the antibiotic age and should not be forgotten. Receiving a certificate of commendation for Rotation 3, but not previously listed in the newsletter is Syed Nazeer. It is the admitting intern's responsibility to notify the patient's primary resident when a patient with an established relationship with another resident is admitted to a hospital service. While the patient's primary resident will often be unavailable to provide care for a particular hospitalization, the primary resident should make every effort to visit the patient socially, and to be aware of the hospital situation for ongoing follow-up in the clinic setting. For the system to work, interns must make special note of patients admitted from residency clinics and special effort the following workday to notify the primary resident of the patient's admission.