LIMIERRE'S SYNDROME: DISEASE, WHICH MUST BE REMEMBERED
Limierre's syndrome (LS) is the most frequent clinical variant of septic infection caused by Fusobacterium necroforum. Disease starts with tonsillopharyngitis followed by thrombosis of v. jugularis interna (often unilateral), multiple lung infiltrates forming with subsequent fast cavitations. High-resolution neck computed tomography (CT) is most useful both for diagnosing of jugular thrombosis and fluid/gas collection. Thorax CT is helpful in discovering of septic pneumonia. Prognosis in LS is depending upon how quick antibacterial treatment was started. Combinations such metronidazole + penicillin derived antibiotic ore metronidazole + clindamycin are recommended. Authors present the case of typical LS, which starts with tonsillopharyngitis subsequent marked left-sided neck edema and fast progressing multifocal destructive embolic pneumonia. Ultrasound angioscaning failed to visualize left jugular veins. Occlusive thrombosis was suspected. Prolonged course of septic pneumonia in the patient was probably due of not optimal initial antibiotics choice.