Rare and risky: a unique case of concurrent chronic pulmonary aspergillosis and lemierre syndrome

Area of Science:

• Medicine
• Infectious Diseases
• Pulmonology

Background:

• Lemierre syndrome is a rare but severe condition, often a complication of upper respiratory tract infections.
• It involves internal jugular vein thrombosis and septic emboli, potentially leading to fatal outcomes if untreated.
• The syndrome's recognition has declined, increasing risks of delayed diagnosis and adverse events.

Purpose of the Study:

• To report a unique case of Lemierre syndrome co-occurring with chronic pulmonary aspergillosis.
• To emphasize the importance of considering Lemierre syndrome in patients with sepsis, especially after respiratory infections.
• To highlight diagnostic challenges and the need for comprehensive evaluation in complex cases.

Main Methods:

• Case presentation of a 46-year-old patient with pneumogenic sepsis.
• Diagnostic workup including imaging and microbiological investigations.
• Review of clinical presentation and treatment course.

Main Results:

• The patient presented with symptoms suggestive of severe sepsis.
• Simultaneous diagnosis of Lemierre syndrome and chronic pulmonary aspergillosis was established.
• Successful management of both conditions was achieved.

Conclusions:

• Lemierre syndrome, though rare, remains a critical diagnosis to consider in sepsis of respiratory origin.
• The co-existence with chronic pulmonary aspergillosis presents a diagnostic and therapeutic challenge.
• Prompt recognition and integrated management are crucial for improving patient outcomes.