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Lemierre syndrome: case report.

Rodrigo de Oliveira Veras1, Linda Luísa Barasuol1, Carolina Pedrassani de Lira2

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Jornal Vascular Brasileiro
|February 22, 2019
PubMed
Summary

Lemierre syndrome, a rare complication of oropharyngeal infections, involves internal jugular vein thrombophlebitis and potential septic emboli. This case highlights tooth extraction as a rare trigger, emphasizing prompt diagnosis and antibiotic treatment.

Keywords:
Lemierre syndromepulmonary embolismthrombophlebitistooth extraction

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Area of Science:

  • Infectious Diseases
  • Vascular Surgery
  • Otolaryngology

Background:

  • Lemierre syndrome is a rare but serious condition characterized by septic thrombophlebitis of the internal jugular vein, typically following an oropharyngeal infection.
  • It often presents with metastatic septic emboli to the lungs or other organs, necessitating prompt recognition and management.

Observation:

  • A 37-year-old female presented with facial edema, dyspnea, and fatigue following a tooth extraction.
  • Clinical examination revealed signs of respiratory distress and localized facial swelling.
  • Cervical computed tomography confirmed septic thrombophlebitis of the internal jugular vein, with chest imaging indicating septic emboli.

Findings:

  • The patient's symptoms were attributed to Lemierre syndrome, with a recent tooth extraction identified as a rare predisposing factor.
  • Computed tomography is crucial for diagnosing internal jugular vein thrombophlebitis and associated septic emboli.
  • Pulmonary embolization is a common complication, observed in up to 97% of cases.

Implications:

  • This case underscores the importance of considering Lemierre syndrome in patients with oropharyngeal infections and systemic symptoms, even with atypical triggers like dental procedures.
  • Early diagnosis via imaging and initiation of broad-spectrum antibiotics are critical for favorable outcomes.
  • While surgery is rarely required, a multidisciplinary approach ensures comprehensive patient care.