Jugular Vein Septic Phlebitis (Lemierre's Syndrome)
- Suspect in teenagers with pharyngitis/fever and neck pain/swelling.
- May occur as a rare complication of otitis media, tonsillitis, or dental infections.
Usual Pathogens
Polymicrobial (1/3):
Oral anaerobes
Streptococcus spp
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Surgical drainage as appropriate | ||
| + | ||
| Penicillin | 150,000-250,000 units/kg/d IV div q4-6h | 6-12 weeks |
| + | ||
| Metronidazole | 30mg/kg/d IV div q8h |
ß-lactam allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Clindamycin | 30-40mg/kg/d IV div q8h | 6-12 weeks |
| + | ||
| Metronidazole | 30mg/kg/d IV div q8h |