Lemierre's Syndrome: A Case Report

Abstract

Lemierre's syndrome is a condition in which an oropharyngeal infection progresses to sepsis and thrombophlebitis of the internal jugular vein. Although the incidence of this syndrome has fallen dramatically since the widespread use of antibiotic therapy to treat streptococcal pharyngitis, it should still be suspected in otherwise healthy young patients presenting with the triad of prolonged pharyngitis, lateral neck pain, and septic symptoms. In this report, we explore a unique case of Lemierre's syndrome complicated by hypercoagulability and ineffective initial antibiotic therapy.

Keywords: jugular vein suppurative thrombophlebitis; lemierre's syndrome; necrobacillosis; post-anginal sepsis; postanginal sepsis; septic thrombophlebitis.

Figure 1. Initial CT with contrast demonstrating bilateral palatine tonsil enlargement.

Figure 2. Initial CT with contrast demonstrating a filling defect in the right internal jugular vein.

Figure 3. Chest CT with contrast demonstrating pleural effusion (black arrows), consolidation (yellow arrows) and nodular opacities (white arrows).

Figure 4. Axial and sagittal view of CT with contrast demonstrating a fully occluded right internal jugular vein (white arrows).