Lemierre's Syndrome: A Neglected Disease with Classical Features

A Rare Case of Lemierre's Syndrome Caused by Streptococcus pyogenes

Lemierre's syndrome (LS) is a rare condition characterized by septic thrombophlebitis of the internal jugular vein (IJV). Typically, the primary infection originates in the oropharynx, progressing to the lateral pharyngeal space, IJV, and potentially leading to bacteremia. Through septic embolization, these patients can develop severe complications, underscoring the importance of early diagnosis. We present a case of LS in a 33-year-old female who initially presented to the emergency department with odynophagia and was diagnosed with acute tonsillitis. She was discharged with antibiotics. However, one week later, she returned with sudden-onset dyspnea. After a comprehensive workup during her hospital stay, an LS caused by Streptococcus pyogenes was diagnosed. The patient was treated with anticoagulation and antibiotics, resulting in a favorable clinical outcome. This case highlights the importance of maintaining a high level of clinical suspicion for LS in the differential diagnosis of complicated tonsillitis, emphasizing the critical role of early identification and appropriate management. Additionally, we aim to review the pathophysiology, management strategies, and current literature on LS, offering insights into the clinical approach to these rare yet potentially fatal cases.

Lemierre's syndrome-A diagnostic challenge

In this case report, we present a young man with Lemierre's syndrome, which is a potentially fatal condition most commonly caused by the bacterium Fusobacterium necrophorum. When Lemierre's syndrome is suspected, it is important to consider X-ray, ultrasound, and CT scan, as they can bring tremendous diagnostic value.

Forget-me-not: Lemierre's syndrome, a case report

Background: Familiarity breeds complacency. One case of sore throat can start to sound like another. However, even common viral and bacterial infections can lead to serious sequelae. Clinicians cannot make a diagnosis if they do not consider it in their differential.Case: The presentation - and subsequent hospitalization - of a septic 19 year-old male college student is described. Despite brief interval improvement, he became hypoxic one week after developing a sore throat and was ultimately diagnosed with Lemierre's syndrome (septic thrombophlebitis of the internal jugular vein) via blood cultures and advanced imaging.Conclusions: Though rare, Lemierre's syndrome carries a high mortality rate. It should be considered an emergent complication of head and neck infections, particularly in young adults.

Lemierre's syndrome: A rare cause of septic emboli in a young adult

Lemierre's syndrome is a deadly disease that is often over-looked due to its rarity. In this report, a 21-year-old Caucasian woman, with no past medical history, presented to a walk-in in clinic and twice to an emergency department between January 30th, 2020 and February 5th, 2020 for progression of fevers, sore throat, neck, and pleuritic chest pain. The patient was sent home her first 2 visits with an incorrect diagnosis. Despite having a presentation consistent with Lemierre's syndrome, on her third visit, she underwent an extensive work-up investigating other etiologies prior to receiving a correct diagnosis and adequate treatment. This case demonstrates how a thorough history and physical exam can aid Radiologists in expediting the diagnostic process for a potentially fatal disease. Although rare, a history of pharyngitis and neck pain in a septic patient should help Radiologists to exclude more common etiologies which, through their investigations, prolong life-saving treatment.

Lemierre's Syndrome

Lemierre's syndrome is a rare, life-threatening condition, which may be fatal if not properly treated. This disease refers to thrombophlebitis of the internal jugular vein, which is the result of bacterial sore throat infection (usually in the form of pharyngitis) that extends into the parapharyngeal space. However, it can result from other infective foci in the ear, nose, parotid glands, and paranasal sinuses. The bacteria typically responsible is Fusobacterium necrophorum. Here, we describe a case of Lemierre's syndrome that occurred in a 20-year-old female who presented with neurological deficits following a two-week history of upper respiratory tract infection. Our case displayed typical findings of this rare condition with a review of the previous literature and also to emphasize the importance of high index of suspicion to reduce the mortality of this disease.

Lemierre's Syndrome Associated with Mechanical Ventilation and Profound Deafness

Lemierre's syndrome is a rare disorder that is characterized by anaerobic organisms inducing a thrombophlebitis of the internal jugular vein (IJV) following a course of oropharyngeal infection. It often occurs in young and healthy patients. Clinicians continuously misinterpret early symptoms until infection disseminates systematically and life-threatening sepsis transpires. We report the case of a 58-year-old female developing Lemierre's syndrome accompanied by invasive ventilation support and a profound deafness requiring the implementation of a cochlear implant. This is one of two reported cases of Lemierre's syndrome associated with mechanical ventilation support and the only case associated with a cochlear implant.