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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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How is Lemierres syndrome/disease diagnosed , how does the

Resolved Question:

How is Lemierre's syndrome/disease diagnosed , how does the bloodwork reflect this disease?
Submitted: 6 years ago.
Category: Health
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.



Thank you for writing in today. Lemierre's syndrome is associated with bacterial infection. The extent of diagnostics utilized to make a diagnosis can depend on the patient's presentation of the illness. Ultrasound, CT scan, or MRI can be used to evaluate the thrombophlebitis. Chest xray may be useful to determine any respiratory involvement. As for labs, since this is associated with bacterial infection, the white blood cell count may be elevated, there may be a differential shift in the white count, the C-reactive protein may be elevated, the sed rate may be elevated, and blood cultures may or may not be positive. If there is an obvious site of infection, such as a wound or inflamed joint, cultures may be helpful. Finally, there may be some abnormal labs associated with organ involvement, such as liver or renal associated changes. I hope this helps. If you have any additional questions or concerns, please let me know. Lisa

Customer: replied 6 years ago.
my son had a sore throat that suddenly was so severe he had trouble swallowing, a fever, chills, swollen red tonsils, hoarse voice, and trouble breathing , he was given a strep test and I
was told he had pharyngitis and hyperventilating....I didn't agree with the diagnososis , we were sent home and 7 hours lateir , my son collapsed and died 1 day later and still no answers, they claim necrotizing pharyngo tracheo bronchitis....
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.



Thank you for responding. I am so sorry to hear about your son. This must be extremely difficult. I completely understand why you need answers. Answers help provide closure. At this point, there really isn't enough information for me to provide an opinion supporting or refuting a diagnosis. At any rate, Lemierre's disease is very rare. There are a number of different things, including necrotizing bacterial infection, that could have also caused his death. The trouble breathing would be the biggest red flag. At this point, you could consider requesting his medical records, particularly those while hospitalized. (I assume he was hospitalized after collapsing.) This may help you feel more comfortable with the diagnosis or at least the efforts to identify the cause of his symptoms. Unfortunately, regardless of the diagnosis, this does sound to have been a very aggressive infection. Unfortunately, with some infections, even common ones such as influenza, they progress so quickly that the ability to intervene may not be enough. Again, I am so sorry to hear about your loss. I hope you and your family are able to find some comfort. If you have additional questions or concerns, please let me know. Lisa

Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.

One thing I do want to mention is a throat culture. If his strep test was negative, his provider may have sent out a backup throat culture. These usually are done at an outside lab and results are available after a few days. If he had a necrotizing form of bacterial infection, there may be some information on the throat culture report. This may help you to understand what caused this infection. At any rate, you could ask his provider if this was done; however, unfortunately, it won't change the unfortunate outcome, but it may give you some of the answers you need. Take care. Lisa

Customer: replied 6 years ago.
No throat culture was taken only a quick strep test
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.

That's unfortunate. I hope you can get some answers. Lisa

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