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Diagnosing Lemierre s Syndrome as the Cause of Multifocal Pneumonia During the COVID-19 Pandemic #MMPMID34437666
Soares C; Blackwood K; Vecchio M; Francis ER; Zhu S; Johnson J
R I Med J (2013) 2021[Sep]; 104 (7): 46-49 PMID34437666show ga
A 21-year-old male with no past medical history presented with a sore throat, cough, and shortness of breath after attending a party days earlier. He was initially treated for community-acquired pneumonia, but subsequently developed a new oxygen requirement. CT imaging of the chest showed multifocal airspace disease, concerning for COVID-19. Testing for SARS-CoV-2 was negative by RT-PCR and antibody testing. Blood cultures subsequently grew Streptococcus anginosus. A CT scan of his neck demonstrated a right peritonsillar abscess and right internal-jugular thrombus, consistent with Lemierre's syndrome. He underwent incision and drainage of the peritonsillar abscess and completed 4 weeks of IV antibiotics, which improved his symptoms. It is important to recognize that the differential diagnosis of multifocal pneumonia is broad and includes Lemierre's syndrome. The COVID-19 pandemic presents challenges with regards to anchoring bias for multifocal pneumonia.