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Case Reports
. 2020 Oct 30;13(10):e236201.
doi: 10.1136/bcr-2020-236201.

Lemierre's syndrome: a forgotten life-threatening entity

Rita Gama  1 , Manuel Sousa  2 , Fernanda Castro  2 , Artur Condé  2
Affiliations
Case Reports

Lemierre's syndrome: a forgotten life-threatening entity

Rita Gama et al. BMJ Case Rep. .

Abstract

Lemierre's syndrome is a very rare but potentially fatal condition. It mainly affects adolescents and young adult males, and usually arises as a serious complication of pharyngitis or peritonsillar abscess. It is characterised by the triad of internal jugular vein septic thrombophlebitis, septic emboli (mostly pulmonary) and the isolation of the agent 'Fusobacterium necrophorum' in sterile fluids. In this report, it is described a case in which the nonspecific and subtle clinic made the diagnosis difficult to reach. In fact, only the dissociation between flu-like symptoms and the presence of significant changes in the blood tests (suggestive of acute bacterial infection), led to the request for imaging tests, which proved to be essential for the final diagnosis and subsequent control of the disease. This case report aims to increase the awareness among Ear, Nose and Throat (ENT) residents, paediatricians and family doctors about the existence of this entity and its potential life-threatening nature.

Keywords: ear; infections; nose and throat.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The cervical ultrasound revealing thrombosis of the proximal portion of the left internal jugular vein; no abscessed collections were found in the cervical spaces.
Figure 2
Figure 2
CT scan images. (A) axial view showing oropharyngeal oedema and cervical reactive ganglionic formations on the left side of the neck; (B) coronal view showing thrombosis of the cranial portion of the left jugular vein.
Figure 3
Figure 3
CT scan images. Axial view of thoracic CT scan showing small septic pulmonar emboli.
See this image and copyright information in PMC

References

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