Skull base osteomyelitis and cranio-cervical junction instability as long-term sequelae of Lemierre syndrome: A case...

The "classic" presentation of Lemierre syndrome is a post-anginal sepsis with internal jugular thrombophlebitis and metastatic infection caused by Fusobacterium necrophorum or other Fusobacterium species. Skull base and cervical osteomyelitis are rare complications of Lemierre syndrome and cranio-cervical junction instability is a rare complication of head and neck infections overall. Herein, we report a case of Lemierre syndrome that was complicated by skull base and cervical spinal osteomyelitis, leading to CN XII palsy, atlanto-axial instability, and basilar invagination. At the time of this report, the patient is being managed non-operatively and has been advised to avoid contact sports to prevent spinal cord injury. In cases where Lemierre syndrome is complicated by skull base osteomyelitis, clinicians may consider adequate follow-up to monitor for long-term sequelae.