{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:46:24Z","timestamp":1786387584830,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,10,1]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>The SARS-CoV-2 outbreak has disrupted the delivery of routine healthcare services on a global scale. With many regions suspending the provision of non-essential healthcare services, there is a risk that patients with common treatable illnesses do not receive prompt treatment, leading to more serious and complex presentations at a later date. Lemierre\u2019s syndrome is a potentially life-threatening and under-recognised sequela of an oropharyngeal or dental infection. It is characterised by septic embolisation of the gram-negative bacillus <jats:italic>Fusobacterium necrophorum<\/jats:italic> to a variety of different organs, most commonly to the lungs. Thrombophlebitis of the internal jugular vein is frequently identified. We describe an atypical case of Lemierre\u2019s syndrome involving the brain, liver and lungs following a dental infection in a young male who delayed seeking dental or medical attention due to a lack of routine services and concerns about the SARS-CoV-2 outbreak.<\/jats:p>","DOI":"10.1136\/bcr-2020-239269","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T14:25:14Z","timestamp":1602339914000},"page":"e239269","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Late presentation of \u2018Lemierre\u2019s syndrome\u2019: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminated <i>Fusobacterium necrophorum<\/i> infection during the global COVID-19 pandemic"],"prefix":"10.1136","volume":"13","author":[{"given":"Fergal","family":"Howley","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine, St James's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"O'Doherty","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, St James's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"McEniff","sequence":"additional","affiliation":[{"name":"Department of Radiology, St James's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"O'Riordan","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, St James's Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,10]]},"reference":[{"key":"2025082711144951000_13.10.e239269.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-264"},{"key":"2025082711144951000_13.10.e239269.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-008-0496-4"},{"key":"2025082711144951000_13.10.e239269.3","doi-asserted-by":"crossref","unstructured":"Lee WS , Jean SS , Chen FL , et al . Lemierre\u2019s syndrome: A forgotten and re-emerging infection. J Microbiol Immunol Infect 2020.","DOI":"10.1016\/j.jmii.2020.03.027"},{"key":"2025082711144951000_13.10.e239269.4","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2003.014274"},{"key":"2025082711144951000_13.10.e239269.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.006631"},{"key":"2025082711144951000_13.10.e239269.6","first-page":"145561320923893","article-title":"The effects of the COVID-19\/SARS-CoV-2 pandemic outbreak on otolaryngology activity in Italy","author":"Ralli","year":"2020","journal-title":"Ear Nose Throat J"},{"key":"2025082711144951000_13.10.e239269.7","first-page":"e398","article-title":"Lemierre's syndrome: a serious complication of an odontogenic infection","volume":"14","author":"Rosado","year":"2009","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"2025082711144951000_13.10.e239269.8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-210235"},{"key":"2025082711144951000_13.10.e239269.9","doi-asserted-by":"crossref","unstructured":"Shahani L , Khardori N . Fusobacterium Necrophorum - beyond Lemierre\u2019s syndrome. BMJ Case Rep 2011.","DOI":"10.1136\/bcr.07.2011.4527"},{"key":"2025082711144951000_13.10.e239269.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bcr-2017-222723","article-title":"Lemierre's syndrome: a pain in the neck with far-reaching consequences","volume":"2018","author":"Stubington","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025082711144951000_13.10.e239269.11","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811700909"},{"key":"2025082711144951000_13.10.e239269.12","unstructured":"Holland K . Dentists in dire need of support, says dental association chief. The Irish times. health, 2020. Available: https:\/\/www.irishtimes.com\/news\/health\/dentists-in-dire-need-of-support-says-dental-association-chief-1.4238406 [Accessed 19 Jun 2020]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:14:58Z","timestamp":1756318498000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10,10]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/bcr-2020-239269"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239269","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}