[Fever and dysphagia of a young woman]

Area of Science:

• Infectious Diseases
• Vascular Surgery
• Internal Medicine

Background:

• Lemierre syndrome is a rare but serious complication of oropharyngeal infections, often presenting with thrombophlebitis of the internal jugular vein.
• Early recognition is critical as delayed diagnosis can lead to severe morbidity and mortality.
• Pharyngitis, a common throat infection, can predispose individuals to this condition.

Observation:

• A 39-year-old patient presented with septicemia and dysphagia, complicating a recent pharyngitis treated with antibiotics.
• Radiologic findings revealed pulmonary infiltrates and internal jugular vein thrombosis.
• Despite the absence of bacterial detection, clinical presentation strongly suggested Lemierre syndrome.

Findings:

• The patient was diagnosed with Lemierre syndrome based on clinical and radiological evidence.
• Treatment involved a change in antibiotic therapy and initiation of anticoagulation.
• The patient experienced a favorable clinical course following the adjusted treatment regimen.

Implications:

• This case highlights the importance of considering Lemierre syndrome in patients with severe pharyngitis and signs of sepsis, even without positive bacterial cultures.
• Effective management requires prompt anticoagulation and appropriate antibiotic selection.
• The case underscores the significant morbidity associated with Lemierre syndrome, necessitating prolonged hospitalization.