Lemierre's Syndrome in the External Jugular Vein Precipitated by COVID-19 Infection

Abstract

Lemierre's syndrome is a condition when an oropharyngeal infection, typically from Fusobacterium necrophorum, causes thrombophlebitis of the internal jugular vein. There have been few case reports of Lemierre's syndrome affecting the external jugular vein, but to our knowledge, this is the first case report where COVID-19 infection is the prime suspect for causing this syndrome. SARS-CoV-2 infection, known to cause hypercoagulability and immunosuppression, increases the risk of deep venous thrombosis and secondary infections. We report a case of a young male with no known risk factors who developed Lemierre's syndrome as a complication of COVID infection.

Keywords: coronavirus disease 2019 (covid-19); external jugular vein thrombosis; jugular vein thrombophlebitis; lemierre’s syndrome; sars-cov-2 (severe acute respiratory syndrome coronavirus-2).

Figure 1. CT scan of neck axial view showing thrombus in the left external jugular vein (black arrow)

Figure 2. CT scan of the neck coronal section showing thrombus in the left external jugular vein and swelling of left side soft tissue

Figure 3. CT thorax showing septic emboli bilaterally (arrows)