Lemierre, s syndrome is the occurrence of thrombophlebitis of the internal jugular vein (IJV) in the presence of an oropharyngeal infection. Almost uniformly, the causative organism is Fusobacterium necrophorum, a gram-negative anaerobic bacillus.'Although first described in 1900 by Courmont and Cade, 2 it was not until 1936 that the syndrome acquired its current eponym. In an address to the Middlesex Hospital Medical School, Lemierre summarized all that was known about the" post-anginal septica~ mias" and added 20 additional personal case observations? The disease henceforth became known as Lemierre's syndrome but has also been referred to as postanginal septicemia and necrobacillosis. 4, 5

In the preantibiotic era the disease was commonly encountered and well recognized. Onset was typically heralded by an acute oropharyngeal infection, particularly of the tonsils or peritonsillar tissue. Thrombosis of the IJV soon followed with rapidly progressing septicemia and septic emboli, ending in fatality 7 to 15 days from initial onset. Since the advent of antibiotics, however, Lemierre's syndrome has become a rare occurrence, spurring some to call it the" forgotten disease.''6 This dramatic decrease in incidence is likely the result of early, widespread use of penicillins in the treatment of common throat infections. 7'8 Although currently uncommon in the age of antibiotics, death from this condition has been reported as recently as 1983. 9 Consequently, the otolaryngologist should be familiar with its