Lemierre syndrome: from pharyngitis to fulminant sepsis.

We report a case of a previously healthy 33-year-old male who presented to his primary care physician with nausea, vomiting, diarrhoea and fever. One week prior to presentation the patient reported a history of sore throat which he presumed to be a viral infection and sought no medical attention. Upon hospital presentation, the patient was admitted and rapidly progressed to sepsis and respiratory failure. Goal directed therapy was initiated and the patient was intubated. Further clinical work up included blood cultures revealing Fusobacterium varium bacteraemia, and CT and ultrasound imaging demonstrated thrombosis of the internal jugular vein and septic pulmonary emboli. A diagnosis of Lemierre syndrome was made, and antibiotics as well as anticoagulation therapy were initiated. The patient's clinical condition improved with treatment, and he was discharged home on hospital day 12 with completion of an uneventful 4-week course of outpatient antibiotic and anticoagulation therapy.

Coexistence of sarcoidosis and malignancy.

In 1974, Brincker and Wilbek noted a statistically significant increase of malignant tumors among sarcoid patients and speculated that immunologic deficiencies stemming from sarcoidosis may predispose such patients to malignancy. In this article, we describe three additional cases of sarcoidosis and coexisting malignancy. The temporal presentation, radiographic features, and histologic findings are discussed in detail. The evidence for and against a proposed link between sarcoid and malignancy is reviewed.