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[A case of Lemierre syndrome]
Mitsutoshi Hayashi1, Isao Yamawaki, Junko Nakata
1Department of Internal Medicine, Tokyo Women's Medical University, Daini Hospital, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, Japan, 116-8567.
Summary
Lemierre syndrome, a rare but serious complication of throat infections, involves internal jugular vein thrombophlebitis and metastatic infections. Early consideration in severe tonsillitis cases is crucial for timely diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Otolaryngology
Background:
- Lemierre syndrome is a rare thrombotic complication of oropharyngeal infections.
- It often presents insidiously, complicating initial diagnoses like peritonsillar abscess.
Observation:
- A 30-year-old woman presented with severe tonsillitis, progressing to Lemierre syndrome.
- Clinical deterioration included high fever, internal jugular vein thrombophlebitis, and multiple pulmonary metastatic foci.
Findings:
- Neck CT confirmed left internal jugular vein thrombus.
- Thoracic CT revealed pulmonary cavities and right-sided pleural effusion.
- Intravenous clindamycin and cefepime led to progressive clinical improvement.
Implications:
- This case highlights the importance of considering Lemierre syndrome in severe pharyngotonsillitis.
- Prompt diagnosis and appropriate antibiotic therapy are vital for managing this potentially life-threatening condition.