Page "Lemierre's syndrome" Paragraph 16

During the primary infection, F. necrophorum colonizes the infection site and the infection spreads to the parapharyngeal space.

The bacteria then invade the peritonsillar blood vessels where they can spread to the internal jugular vein.

In this vein, the bacteria cause the formation of a thrombus containing these bacteria.

Furthermore, the internal jugular vein becomes inflamed.

This septic thrombophlebitis can give rise to septic microemboli that disseminate to other parts of the body where they can form abscesses and septic infarctions.

The first capillaries that the emboli encounter where they can nestle themselves are the pulmonary capillaries.

As a consequence, the most frequently involved site of septic metastases are the lungs, followed by the joints ( knee, hip, sternoclavicular joint, shoulder and elbow ).

In the lungs, the bacteria cause abscesses, nodulary and cavitary lesions.

Pleural effusion is often present.

Other sites involved in septic metastasis and abscess formation are the muscles and soft tissues, liver, spleen, kidneys and nervous system ( intracranial abscesses, meningitis ).