A rare case of MRSA associated Lemierre's syndrome

Lemierre's syndrome, or postanginal sepsis, is an uncommon but potentially fatal infection of the internal jugular vein. The combination of bacteremia, internal jugular vein thrombophlebitis, and metastatic septic emboli secondary to acute pharyngeal infections is characteristic of Lemierre's syndrome. Isolated pathogens are typically oral anaerobic bacteria, most commonly Fusobacterium necrophorum. While the incidence of Lemierre's syndrome has declined over the years, the proportion of cases caused by uncommonly implicated bacteria have been increasingly cited in the literature (1). In this case report, we introduce a novel presentation of Lemierre's syndrome in a patient who presented to the emergency department with neck swelling and shortness of breath and was found to have infectious myositis and bacteremia with methicillin-resistant Staphylococcus aureus. Clinicians should be vigilant of underlying thrombus in patients with neck swelling and infectious myositis as our patient's internal jugular vein thrombus was missed on initial computed tomography read.