Internal jugular vein septic thrombophlebitis (lemierre syndrome) as a complication of pharyngitis

Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A β-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome.