{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:40:53Z","timestamp":1780659653766,"version":"3.54.1"},"reference-count":37,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,3,28]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>We present here the challenging case of severe Lemierre syndrome in a healthy woman in her late twenties, whose clinical presentation was characterised by lung abscesses and disseminated systemic abscesses in the brain, the abdomen and the soft-tissues, as a likely consequence of a patent foramen ovale. Blood cultures were positive for <jats:italic>Fusobacterium necrophorum<\/jats:italic> and a right lingual vein thrombosis was detected at a late stage when the patient developed a septic shock. Initial antimicrobial therapy with metronidazole and ceftriaxone was modified to meropenem due to progressive worsening. The patient underwent laparoscopy and neurosurgical drainage of a cerebral abscess. She spent many days in the intensive care unit and recovered fully after 6 weeks on meropenem therapy. Although considered rare, the incidence of Lemierre syndrome, a potentially life-threatening condition, is increasing. The clinician should promptly recognise and treat it while being aware of its potential atypical presentations.<\/jats:p>","DOI":"10.1136\/bcr-2023-254638","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T11:01:42Z","timestamp":1682074902000},"page":"e254638","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Complex Lemierre syndrome with multisystemic abscesses"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9862-4652","authenticated-orcid":false,"given":"Johan","family":"Bourgeaud","sequence":"first","affiliation":[{"name":"Internal Medicine, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1964-9099","authenticated-orcid":false,"given":"Beno\u00eet","family":"Delabays","sequence":"additional","affiliation":[{"name":"Internal Medicine, CHUV, Lausanne, 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