[A cervical necrotizing cellulitis revealing a Lemierre syndrome]
C Assouan1, A Salami1, E Anzouan-Kacou1
1Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire.
Summary
Lemierre syndrome, a rare septic thrombophlebitis of the internal jugular vein (IJV), requires prompt suspicion. Early diagnosis and treatment, including antibiotics and surgery, are crucial for favorable outcomes in this serious condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Vascular Surgery
Background:
- Lemierre syndrome is a rare but severe condition characterized by septic thrombophlebitis of the internal jugular vein (IJV).
- It typically follows an oropharyngeal infection, often presenting as a painful neck swelling.
Observation:
- A case of Lemierre syndrome is presented in a 45-year-old patient with angina and necrotizing cellulitis of the neck.
- Doppler ultrasound and CT scans confirmed internal jugular vein thrombophlebitis.
- Blood and pus cultures were negative, with no specific pathogen identified.
Findings:
- The patient received a treatment regimen including antibiotics, heparin, and surgical intervention.
- Surgical debridement of necrotic tissues, ligation and section of the IJV, and thrombus extraction were performed.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Lemierre syndrome, though uncommon, is a critical diagnosis that should be considered in patients with oropharyngeal infections and significant neck swelling.
- Systematic suspicion and timely intervention are vital for managing this potentially life-threatening disease.
- This case highlights the importance of a multidisciplinary approach involving antibiotics, anticoagulation, and surgical management.
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