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Published on: June 14, 2020

An 11-year-old boy with pharyngitis and cough: Lemierre syndrome

Patricia Mação1, Candida Cancelinha, Paulo Lopes

  • 1Department of Emergency Service and Infectious Disease Unit, Hospital Pediátrico Coimbra, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal. patriciamacao@gmail.com

BMJ Case Reports
|April 26, 2013
PubMed

Insights

This case highlights Lemierre syndrome, a serious complication of pharyngitis. Early diagnosis and treatment of this rare condition are crucial to prevent severe outcomes.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Critical Care Medicine

Background:

  • Pharyngitis is common in children, usually treated with antibiotics like amoxicillin.
  • Complications can arise, necessitating a broader differential diagnosis when symptoms worsen.

Observation:

  • An 11-year-old boy with pharyngitis developed worsening symptoms including cough, fever, lethargy, and respiratory distress.
  • Clinical presentation evolved to include neck pain, a palpable neck mass, internal jugular vein thrombosis, and septic emboli.

Findings:

  • Radiographic findings initially suggested pneumonia, but subsequent investigations revealed Lemierre syndrome.
  • Diagnosis was confirmed by ultrasound and CT scans showing internal jugular vein thrombosis, parapharyngeal abscess, and septic pulmonary emboli.

Implications:

  • This case underscores the importance of considering Lemierre syndrome in pediatric patients with pharyngitis and progressing symptoms.
  • Prompt diagnosis and multidisciplinary management, including antibiotics and anticoagulation, are vital for favorable outcomes and preventing fatal complications.

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