Lemierre Syndrome Presenting as Tender Goiter.

Area of Science:

• Internal Medicine
• Infectious Diseases
• Vascular Surgery

Background:

• Lemierre syndrome (LS), characterized by internal jugular vein (IJV) thrombosis, is a severe complication often following oropharyngeal infections.
• While typically associated with head and neck infections, LS can also stem from cervical lymph node infections or abscesses.

Observation:

• A case report details an elderly woman with a 20-day history of fever, odynophagia, and anterior neck swelling.
• Physical examination revealed a congested posterior pharyngeal wall, bilateral tonsillitis, and a tender goiter.

Findings:

• Investigations confirmed a diagnosis of Lemierre syndrome (LS).
• The patient's presentation mimicked thyroid swelling, underscoring a less common clinical manifestation of LS.

Implications:

• This case highlights the critical importance of considering IJV thrombosis in patients presenting with neck swelling, even when thyroid pathology is suspected.
• Prompt recognition and management of LS with advanced antibiotics and anticoagulation are vital to prevent mortality.