Lemierre syndrome. A forgotten disease. case report and review of literature

Abstract

Introduction: Lemierre syndrome is a serious condition that associates oropharyngeal infection and thrombosis of the internal jugular vein (IJV) with subsequent distant septic emboli, most frequently in the lungs. Case presentation: A 70-year-old female with retropharyngeal abscess developed features of Lemierre syndrome. The condition was managed with serial aspiration of the abscess and prolonged usage of intravenous antibiotics. Discussion: Lemierre syndrome is most frequently caused by the anaerobic bacterium, Fusobacterium necrophorum. Although rare, there is evidence of a resurgence in the condition in recent years, most probably due to reduced use of antibiotic therapy for sore throats. Although there is a characteristic clinical picture, many clinicians are unaware of this condition, leading to delayed diagnosis with potentially fatal consequences. Conclusion: Early diagnosis of this condition and prompt treatment with intravenous broad spectrum antibiotics results in a complete resolution of this condition. Surgery is indicated in the case of abscess formation.