By Sandra G. Boodman

Special to The Washington Post

When Shannon Aud, a freshman at Virginia Tech, came home for winter break last December, she was looking forward to a few weeks relaxing with her family, hanging out with her friends and skiing at a West Virginia resort. But on Christmas Eve, when she developed a bad sore throat, Aud figured she'd caught a virus from her boyfriend.

Aud, who had never been seriously ill, expected she would be fully recovered in a few days. She had no inkling that she was about to spend several weeks in the hospital, followed by months recuperating from a disease that was greatly feared 100 years ago but is nearly unknown today.

"At first I was annoyed at losing my Christmas break," recalled Aud, now 19, an international studies major from central Virginia. "Then I remember feeling really bad and that I just wanted to be home. I do know that I could not have gotten through this without my mother. She was there every day."

For Susan Aud, a senior research scientist at the U.S. Department of Education, the events involving her oldest child remain vivid.

Shannon's sore throat was soon eclipsed by a high fever and vomiting. Flu, she thought: crummy timing. Determined not to spoil her family's ski trip, Shannon decided to tough it out. She, her mother and her two younger brothers packed up and left as planned on Dec. 26.

After a day spent sleeping in the condo, Shannon felt worse. Her fever sometimes reached 104 degrees, the right side of her neck was visibly swollen and she had wracking chills.

The next day her mother took her to a nearby urgent care center. A doctor gave her a cursory exam and told her she might have strep throat; he prescribed Augmentin, a potent antibiotic. The drug didn't seem to help: Her fever bounced around, sometimes shooting up to 104, at other times dropping to nearly normal, which Shannon hoped might mean she was getting better. The swelling spread to her face.

After her boyfriend arrived, Shannon said she decided to "give it the old college try" and go skiing. While waiting in a lift line on Dec. 29, she passed out. Susan Aud decided the vacation was over. She quickly packed up her family and drove home, dropping off her younger children at the house before making a beeline to an emergency room with Shannon.

For the next several days, various specialists trooped into her room. They gave her steroids to try to shrink the swelling. She endured painful daily injections of blood thinner into her stomach to dissolve the large clot.

To Susan Aud, two things were becoming increasingly clear: Doctors were stumped and Shannon was deteriorating.

Aud picked up the phone and called her uncle, a plastic surgeon in central Illinois. An hour later, the arrangements had been made: Shannon was headed for Georgetown, where she was admitted to the pediatric intensive care unit.

Doctors took a detailed history and began running tests, and the now familiar specialists appeared. Several hours later, Susan Aud recalls, one of the junior doctors arrived with news of a tentative diagnosis.

Infectious-disease specialist Charlotte Barbey-Morel strongly suspected she had Lemierre disease, also known as Lemierre syndrome, an extremely rare complication of a throat infection that tends to affect otherwise healthy teen-agers and young adults. Dubbed the "forgotten disease" -- it was once common and killed 90 percent of its victims -- Lemierre's was virtually eradicated by penicillin.

Because Shannon's infection was too entrenched to be treated solely by drugs, she underwent surgery to remove her tonsils and a salivary gland and to clean out dead tissue in her jaw. She also required treatment for pneumonia, the result of tiny clots that had settled in her lungs.

She was discharged in mid-January, weighing 95 pounds, 20 pounds less than normal, and remained on IV antibiotics for weeks and a blood thinner for months.

The illness changed her. "I used to be really carefree," she said. "Being in the hospital, there was a feeling of despair I'd never felt before." She returned to Virginia Tech in August.