Fever, headache, cough, shortness of breath, vomiting and diarrhea – an American woman goes to her family doctor with these classic corona symptoms. The blood work shows that something is wrong. She comes to the emergency room and now has a fever of 39 degrees. Her blood pressure is too low and her heart beats 114 times per minute. About 80 strokes are normal.
Der Spiegel reports on the case, citing the specialist journal “BMJ Case Reports”.
Two corona tests remain negative
The patient’s throat was red, the medical team writes in its case report. But she doesn’t have a sore throat or neck pain. But further tests show a whole range of symptoms of the disease: the number of white blood cells is slightly increased, as are the levels of certain liver enzymes and inflammatory markers. The patient also has acute kidney injury and possibly a pulmonary embolism.
These are also possible corona symptoms. But two tests carried out remain negative. Does the corona vaccination possibly play a role? The patient had been vaccinated against Covid-19 just one day before symptoms began.
Patient suffers from Lemierre syndrome
On day two, the family doctor’s office contacts you. In a test, bacteria were detected in a blood culture. The patient is getting progressively worse. On day three, the redeeming news from the laboratory: the bacterium Fusobacterium necrophorum is growing in the blood cultures. This information leads to the correct diagnosis: The patient does not have Covid-19, and the vaccination apparently did not play a role. She suffers from the so-called Lemierre Syndrome .
Lemierre syndrome is an infectious disease that can occur as a long-term consequence of a delayed or untreated bacterial infection of the mouth and throat, explain the experts at “DocCheck”. In most cases it is tonsillitis. The clinical picture usually consists of purulent inflammation of the veins, especially of the jugular vein, and septic embolisms.
Symptoms of Lemierre syndrome
The classic symptoms of Lemierre syndrome are considered
at the start
Diffuse sore throat that radiates to the neck and sometimes to the upper back. Strong fever attacks, sometimes with chills. Patients appear lethargic
about 14 days later
severe diarrhea, vomiting, nausea, rash as complications can include liver and kidney damage, pulmonary embolism
If, as in the case of the patient, organs are also affected, it is referred to as sepsis. Lemierre syndrome is therefore also known as postanginal sepsis. The most common trigger for this is the bacterium Fusobacterium necrophorum, which was also detected in the patient. There is a risk of liver and kidney damage. Pulmonary embolism also often occurs.
Lemierre syndrome is treated with antibiotics and usually intensive care. A new remedy is also working well for the American woman. In an operation, the doctors also open the abscess and allow it to drain. She is recovering well.
“The Forgotten Disease”
As the medical team writes in the case report, Lemierre syndrome used to often be a death sentence. Today it is referred to as a “forgotten disease” because it has become very rare due to the targeted and rapid antibiotic treatment of bacterial infections such as tonsillitis. Only around one person in a million is affected each year.
The medical team has another appeal in its report: Even in post-pandemic times, doctors should think about other possible causes when making a diagnosis – not just Covid-19.