Lemierre syndrome: two cases and a review

Area of Science:

• Otolaryngology
• Infectious Diseases
• Neurology

Background:

• Lemierre syndrome, often termed the "forgotten disease," is characterized by oropharyngeal infection leading to internal jugular vein thrombophlebitis, septic embolization, and bacteremia, typically caused by Fusobacterium necrophorum.
• The incidence of Lemierre syndrome is increasing, particularly among young adults, coinciding with rising antibiotic resistance and diminished clinical awareness.

Observation:

• This study presents two cases of Lemierre syndrome with diverse and severe presentations, including unusual neurological complications.
• One case exhibited 9th to 12th cranial nerve palsies and Horner syndrome, while the other developed polyneuropathy and a frontal lobe infarct, highlighting the syndrome's varied clinical manifestations.

Findings:

• Diagnosis of Lemierre syndrome can be challenging due to variable clinical features and frequently negative blood cultures.
• The re-emergence of this condition underscores the need for increased vigilance and diagnostic suspicion in clinical practice.

Implications:

• Increased awareness of Lemierre syndrome is crucial for timely diagnosis and management, especially given its potential for severe morbidity and neurological sequelae.
• Further research in otolaryngology journals is warranted to better understand and address this increasingly prevalent infectious disease.