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"\n\tAdvertisement - Continue Reading Below\n\t\n\nThe Symptoms\n\nJenna West*  will never forget the sore throat that started it all. The red, raw achiness made swallowing hurt, and it wouldn't go away with antibiotics. For two weeks, she suffered through it, along with a fever and extreme fatigue.\"That tired feeling was way stronger than I'd ever had before,\" West recalled recently. It was so overpowering that she slept through a doctor's appointment, which she had never done before.  She was frustrated to miss it since she was about to begin an MBA program and wanted to recover in time for the new semester.When she made it to the doctor, she was diagnosed with mononucleosis, a virus whose symptoms are exhaustion, fever and sore throat. It occurs commonly in young people like West, who was 22 years old.But then, in the middle of the night, she woke up with a heavy feeling in her lungs. Breathing was hard.It's just the mono, she told herself, not terribly alarmed. She woke up her dad anyway. The next morning, he took her straight to the emergency room. When she arrived, her fever was up to 103 and she was complaining of chest pain. Doctors rushed to do a CAT scan, which revealed a troubling discovery: clots in her lungs. With her fever so high, they wondered: could there be an infection of the heart?Enter Dr. Grant*, a cardiologist who was called in to rule out endocarditis, which can throw infected clots to the lungs and to the rest of the body. When Dr. Grant performed her examination, West's pulse was astonishingly high: 130. She also had a very elevated white blood cell count.There was another symptom, too. This one was deceptively benign, seemingly unrelated. But Dr. Grant frowned when she noticed it: a swollen right foot. Perhaps West had taken a dramatic fall? But no, West assured her, it had just started to swell on its own.\"With a history like that, obviously she had an infection,\" Dr. Grant said. \"But what about the foot? How do you put it all together?\"Immediately Dr. Grant thought of another case she'd seen a few years earlier \u2014 a man in his 40s who came to the hospital with a sore throat, clots in his lungs, and a swollen leg. She suspected a very rare disease that she knew existed, but had never seen before \u2014 it starts with a horrible sore throat that becomes an infection of the jugular vein. If the source isn't found and wiped out, it spreads abscesses \u2014 accumulations of infected pus \u2014 to the lungs and then throughout the body at a dizzying pace.\"I had to fight everybody to take him to surgery,\" Dr. Grant said of the male patient. But her persistence paid off \u2014 his infection was discovered in time for him to survive.Meanwhile, it was still West's first day in the hospital, and she was deteriorating fast. Her fever shot up even higher and she was admitted for an overnight stay.\"They were throwing ice on me,\" West remembered, \"and I was so uncomfortable because I just wanted to fall asleep. I didn't really know what was going on.\"Dr. Grant thought she knew full well: the disease was called Lemierre's Syndrome. It strikes young people with healthy immune systems, and the cause is not known. There were only 20 or 30 known cases in the world. Now she just had to convince the other doctors.The trick, she said, \"was to prove that the swollen foot was an infection.\"There was no time to waste.The DiagnosisDr. Grant called an orthopedic surgeon and insisted that he insert a needle into West's ankle to search for pus. He couldn't find any. By now West was in intensive care. Her oxygen level was dropping and she could barely breathe, so doctors had to stick tubes down her throat and into her chest.\n\tAdvertisement - Continue Reading Below\n\t\n\n\"I couldn't actually speak anymore and that was the most terrifying thing,\" West remembered. \"They kept tying my hands down because I kept trying to pull out the tubes to ask what was going on.\"Then an MRI of her ankle came back definitive: there was pus in her ankle. If Dr. Grant was right about the diagnosis, the infection was coming from the jugular vein in her neck. After West had surgery to drain the fluid in her ankle, Dr. Grant demanded that an ear-nose-and-throat doctor perform a CAT scan of West's neck. But that doctor couldn't see any abscesses and he refused to take West into exploratory surgery to test Dr. Grant's diagnosis.At that point, West \"looked like she was going to die,\" Dr. Grant said. \"Everything was shutting down because we weren't getting to the source of the infection and there was constant bacteria going out.\"\n\nEven when an ultrasound of West's neck found a clot in the jugular vein, the ENT doctor did not believe it to be proof of an infection. He suggested it was an isolated clot, but Dr. Grant was sure it was a sign of an infection behind the vein that just didn't show up on the CAT scan.\"I had a big fight with the ENT and infectious disease doctors,\" Dr. Grant recalled, shaking her head. \"I told them, 'You have to remove the infected clot from the jugular vein or she's going to die.'\"Finally, she convinced the ENT doctor and a vascular surgeon to take West to the operating room for surgery on her neck. The \"aha\" moment came when they discovered the abscess behind the vein that Dr. Grant had suspected all along. She was right \u2014 it was Lemierre's. And they found it just in time.The RecoveryAs soon as the source was removed, West started to improve.\"I woke up and everyone was very excited in the room,\" she said. \"I was getting my breathing tubes taken out.\"Her mom and dad were with her the whole time and reassured her the danger had passed. She was going to be fine.But her recovery wasn't quite as smooth as they were hoping. Soon West found herself repeating words and involuntarily moving her head back and forth. An MRI showed three abscesses in her brain, caused by the infected jugular clot before it was removed.\"I thought I was out of the woods,\" West said, \"but having something wrong with my brain \u2014 I was just very scared I wouldn't be myself or would be mentally disabled.\"Luckily a combination of steroids and antibiotics controlled the lesions so she didn't need brain surgery. But getting back to normal life was a slow, painful process.After three weeks in the hospital and two weeks in a rehab center, she had to learn to walk again and had to delay graduate school for a semester. Once she did start to walk, she noticed a lingering pain in her hip bone that turned out to be damage from the original infection. After two bone graft surgeries, she's doing well today, six years later.\"I feel more blessed than bitter that this happened to me,\" she said. \"What are the chances that such a rare disease would get identified so quickly? So many things went right, and Dr.  was one of those things.\"On Father's Day last year, Dr. Grant received a card from West's dad that she keeps right next to her desk. It reminds her why she became a doctor. \"I wanted to send you this note in gratitude after spending Father's Day with my lovely daughter,\" it reads. \"You fought for her life and I never forget your efforts and care. I'm convinced she is alive today because of you.\"\n\tAdvertisement - Continue Reading Below\n\t\n\n*Not their real names.Kira Peikoff is the author of No Time to Die, a thriller about a girl who mysteriously stops aging. It is available now for pre-order, and will be published on Sept. 2, 2014.  Connect with her on Facebook or tweet her @KiraPeikoff.If you've endured a medical mystery and want to share your story, email Kira at cosmomysterydiagnosis@gmail.com.Photo credit: Getty Images"^^<http://www.w3.org/2001/XMLSchema#string>
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