A A Case Report of Lemierre’s Syndrome

Abstract

Lemierre’s syndrome, also known as post-anginal septicemia is a rare entity characterized by a triad of septicemia, internal jugular vein thrombophlebitis and metastatic septic emboli secondary to acute pharyngeal infections. It is commonly seen in young men, with 70% of patients between 16 and 25 years old. Lemierre’s syndrome shows various clinical presentations, thus recognizing this disease in early stage is difficult. Thus, higher clinical suspicion is required to establish the diagnosis of Lemierre’s syndrome. This case report describes a rare presentation of Lemierre’s syndrome in a 64-year-old lady who presented with acute onset of anterior neck swelling associated with progressive fatigue, pain and fever for one-week duration. Physical examination at admission found that she was feverish with tachycardia. Oxygen saturation was maintained under room air, and she was not hypotensive. A neck examination revealed soft anterior neck swelling without evidence of clinical inflammation. Further imaging showed retropharyngeal space collection with thrombosis of bilateral internal jugular veins. She was managed with broad-spectrum antibiotic coverage and subsequently achieved full recovery. Our main objective is to highlight the importance of recognizing and diagnosing Lemierre’s syndrome in older population to achieve appropriate treatment and management.