Lemierre's Syndrome Caused by Klebsiella pneumoniae: A Case Report and Literature Review

Abstract

Lemierre's syndrome is a rare condition that involves anaerobic sepsis following pharyngitis and is characterized by a high mortality rate. It often manifests as a septic embolism within the internal jugular vein due to oropharyngeal infections, leading to vein wall inflammation. Despite modern antibiotics, Lemierre's syndrome remains underdiagnosed and poses a significant threat. We report the case of a 43-year-old man who has alcoholic liver cirrhosis and diabetes mellitus. Symptoms included chest pain, back pain, and neck swelling, with Klebsiella pneumoniae leading to the diagnosis of K. pneumoniae-associated Lemierre's syndrome. Furthermore, K. pneumoniae-associated Lemierre's syndrome is linked to diabetes mellitus and the elderly population. Notably, it showed a tendency for distant metastases, particularly in the lungs and brain. Additionally, central nervous system and renal involvement were observed in a smaller subset of cases.

Keywords: diabetes mellitus; klebsiella pneumonia; lemierre's syndrome; neck swelling; septic embolism.

Figure 1. The computed tomography of the neck showed right neck swelling and reduced compressive blood flow, thrombophlebitis and a small amount of thrombus found in the right internal jugular vein.

Figure 2. The computed tomography of the thorax showed multiple nodular and patchy infiltrates at right lung, and septic pulmonary embolism could be identified.