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Incomplete Lemierre's syndrome: a case report.

Kasper Pledts^1,2, Filip Triest^3,4, Valerie Neirynck^3,4

¹AZ Sint-Lucas, Groenebriel 1, 9000, Ghent, Belgium. kasper.pledts@gmail.com.

Journal of Medical Case Reports

|June 13, 2026

Summary

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Esophageal Achalasia

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...

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Incomplete Lemierre's syndrome, an oropharyngeal infection with septic emboli but no jugular vein thrombophlebitis, requires careful consideration. Anticoagulation therapy is not always necessary for this condition.

Area of Science:

Infectious Diseases
Internal Medicine
Otolaryngology

Background:

Incomplete Lemierre's syndrome is characterized by oropharyngeal infection and septic emboli without internal jugular vein thrombophlebitis.
This condition highlights a nuanced presentation of a known syndrome, necessitating updated diagnostic and therapeutic approaches.

Purpose of the Study:

To raise awareness and strengthen the concept of incomplete Lemierre's syndrome.
To discuss the appropriate use of anticoagulation therapy in incomplete Lemierre's syndrome.

Main Methods:

Case report analysis of two young men presenting with oropharyngeal infection and pulmonary septic emboli.
Identification of Fusobacterium necrophorum as the causative agent in both cases.
Review of clinical presentation, diagnostic criteria, and treatment strategies.

Keywords:

Incomplete Lemierre’s syndrome Pulmonary septic emboli Thrombophlebitis

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Main Results:

Both patients presented with symptoms consistent with incomplete Lemierre's syndrome, lacking internal jugular vein thrombophlebitis.
Fusobacterium necrophorum was successfully isolated, and appropriate antibiotic treatment was initiated.
The cases support the recognition of incomplete Lemierre's syndrome as a distinct clinical entity.

Conclusions:

The presented cases exemplify incomplete Lemierre's syndrome, emphasizing its relevance in clinical practice.
Incomplete Lemierre's syndrome should be included in the differential diagnosis for patients with oropharyngeal infections and septic emboli.
The findings contribute to the ongoing debate regarding the necessity of anticoagulation in incomplete Lemierre's syndrome.