Lemierre's Syndrome Caused by Klebsiella pneumoniae in a Diabetic Patient: A Case Report and Review of the Literature

Abstract

Lemierre's syndrome is characterized by an oropharyngeal infection with internal jugular vein thrombosis followed by metastatic infections in other organs. This infection is usually caused by Fusobacterium spp. In this report, we present a rare case of Klebsiella pneumoniae-associated Lemierre's syndrome in a patient with poorly-controlled diabetes mellitus. The infection was complicated by septic emboli in many organs, which led to the patient's death, despite combined antibiotics, anticoagulant therapy, and surgical intervention. Therein, a literature review was performed for reported cases of Lemierre's syndrome caused by Klebsiella pneumoniae and the results are summarized here.

Keywords: Klebsiella pneumoniae; Lemierre's syndrome; complications; diabetes mellitus; review.

Figure 1

1A. Axial view neck computed tomography showing an irregular-shaped hypodense lesion with rim enhancement along the right carotid space (arrow) 1B. Coronal view neck computed tomography showing thrombosis of the right internal jugular vein up to the right sigmoid sinus (arrow) 1C. Sagittal view neck computed tomography showing thrombosis of the right internal jugular vein up to the right sigmoid sinus (arrow)

Figure 2

2A. Chest radiograph showing alveolar infiltration at the right middle lung area and pleural effusion at the left lower lung area (arrows) 2B. Axial view chest computed topography showing multiple nodules in various sizes with cavitation (white arrows) in both lungs likely to be septic emboli, and pleural effusion (arrowheads). 2C. Coronal view chest computed topography showing multiple nodules in various sizes with cavitation (white arrows) on both lungs likely to be septic emboli, and pleural effusion (arrowheads).