Hematogenous Anaerobic Osteomyelitis

To the Editor: The April 4 Image in Clinical Medicine by Bhatti and Seville 1 is of a man with hematogenous anaerobic osteomyelitis. We would like to add that the combination of a dental infection with fusobacterium and subsequent systemic spread is suggestive of Lemierre's syndrome. In 1936, Lemierre described 20 patients with “anaerobic septicemia,” 18 of whom died. 2 Lemierre's syndrome is characterized by a primary infection of the oropharynx in a young, previously healthy person that results in septic thrombophlebitis of the ipsilateral internal jugular vein with fever and disseminated metastatic abscesses. The syndrome occurs in children with otitis media, . . .