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Lemierre's Syndrome: An Atypical Presentation.
Scott C Chapman1, Elizabeth Andraska1, Rohan N Kulkarni1
1Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Annals of Vascular Surgery
|June 16, 2019
Summary
Septic thrombophlebitis, a rare condition, requires prompt diagnosis. This case highlights Lemierre's syndrome in an asplenic patient with internal jugular vein thrombosis.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Vascular Surgery
Background:
- Septic thrombophlebitis is uncommon due to widespread antibiotic use.
- Early clinical suspicion and evaluation are crucial for diagnosis.
- Lemierre's syndrome is a rare but serious complication of head and neck infections.
Observation:
- A 63-year-old asplenic woman presented with acute neck and chest wall tenderness and swelling.
- She had a history of Streptococcus pneumoniae meningitis and endocarditis.
- Imaging revealed thrombosis of the right internal jugular vein extending to the superior vena cava.
Findings:
- Computed tomography demonstrated inflammatory changes and internal jugular vein thrombosis.
- A retropharyngeal effusion was noted, but no abscesses were identified.
- The findings were consistent with Lemierre's syndrome.
Implications:
- Prompt recognition and management of Lemierre's syndrome are essential.
- This diagnosis should be considered in patients with unexplained neck and chest symptoms.
- Effective treatment can reduce significant morbidity and mortality.