During the fall preseason of 2013, a 19-year-old Division I linebacker (body mass = 104 kg; height = 189 cm) attending a college football camp developed severe throat pain, quickly followed by night sweats, fever, nausea, vomiting, shortness of breath, and generalized body weakness. The athletic trainer believed that the athlete had a cold. Because symptoms did not improve, the athlete was referred to several physicians with different specialties and underwent standard testing. The ears, nose, and throat (ENT) physician recognized the signs and symptoms of Lemierre’s syndrome based on a previous case seen only once in his career. A computed tomography (CT) scan confirmed the presence of a peritonsillar abscess and thrombosis of the left internal jugular vein, which justified further investigation for this rare syndrome. A positive blood culture for Fusobacterium necrophorum confirmed the diagnosis of Lemierre’s syndrome. Several antibiotics and anticoagulation medications were prescribed and the athlete was closely monitored. After two months, he was cleared to play football.
Heather Fahsl and Shannon David are with the Department of Health Nutrition and Exercise Science, North Dakota State University, Fargo, ND.