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Pediatric Lemierre's syndrome: A systematic review

Lama Aldawsari1, Jood Alzohari1, Raneem Khashab1

  • 1Department of Surgery, Division of Otolaryngology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.

International Journal of Pediatric Otorhinolaryngology
|May 13, 2026
PubMed

Insights

Lemierre syndrome (LS) in children is a serious condition involving internal jugular vein septic thrombophlebitis. Early diagnosis and prompt medical management are key to preventing complications and improving outcomes for pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Lemierre syndrome (LS) is a rare but severe condition characterized by septic thrombophlebitis of the internal jugular vein.
  • Prompt diagnosis and appropriate management are critical for favorable prognoses, yet its management in children remains debated.
  • This study provides an updated overview of LS in pediatric patients, focusing on clinical presentation, management strategies, and outcomes.

Purpose of the Study:

  • To update physicians on the clinical presentation, management, and prognosis of Lemierre syndrome in pediatric patients.
  • To consolidate current evidence on the diagnosis and treatment of LS in individuals under 18 years old.
  • To inform clinical practice and improve patient outcomes for pediatric LS cases.

Main Methods:

  • A systematic review was conducted following PRISMA guidelines.
  • Searches were performed on PubMed and Google Scholar using terms related to Lemierre syndrome, thrombophlebitis, internal jugular vein thrombosis, pediatrics, and F. necrophorum.
  • Studies included pediatric patients (<18 years) diagnosed with LS.

Main Results:

  • The review included 53 studies with 143 pediatric cases; mean age was 15.2 years.
  • Fever (92%) was the most common symptom, and *F. necrophorum* was the predominant organism (78.3%).
  • CT imaging (89.5%) effectively detected thrombosis and septic emboli. Antibiotics were universal; anticoagulation was used in 62.2%, surgery in 6%. Complications occurred in 4.2%, with a 1.4% mortality rate.

Conclusions:

  • Early diagnosis and medical management of suspected Lemierre syndrome are crucial for preventing complications.
  • Interdisciplinary collaboration is essential for optimizing patient care and improving outcomes in pediatric LS.
  • Prompt recognition and treatment can significantly reduce morbidity and mortality associated with this condition.
Abstract

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