Lemierre's syndrome: A case report

Abstract

Lemierre's syndrome, which has been uncommon in the antimicrobial era, is an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. This disease usually affects young adults. A typical clinical triad is pharyngitis, a tender, swollen neck, and pulmonary infiltration. We present a case of Lemierre's syndrome in a 23-year-old man who was admitted for hypertensive crisis and congestive heart failure. Diagnosis was made on clinical features, Doppler ultrasonography and computed tomography of the neck. Through antibiotic and anticoagulant therapy, the disease was treated successfully. Similar cases have been reported elsewhere throughout the 1990's, and may be increasing in incidence due to a reduced use of antibiotics for the treatment of pharyngitis. Since limitations to antibiotic use in the treatment of upper respiratory infections are growing annually at present in the Taiwanese medical system, this kind of case may become more frequent. Therefore, we hope this case will attract clinicians' attention.