Endophthalmitis with Bilateral Pulmonary Septic Emboli Secondary to Lemierre’s Syndrome: Case Report

Export Introduction: Over the past decade and a half, there has been a significant increase in Lemierre’s Syndrome (LS), which is a rare condition causing septic thrombophlebitis in the lateral pharyngeal regions of the neck. Diagnosis can be challenging, leading to delayed treatment and high morbidity and mortality. Management involves surgical intervention, intravenous fluids, vasopressors, and broad-spectrum antibiotics. Anticoagulation remains a controversial topic. Case presentation: A 49-year-old man with neck swelling, abscess, and vision loss was admitted to the emergency department (ED). He was febrile and toxic and had acute kidney injury. A retromandibular lesion was identified on high-resolution CT, revealing septic emboli, endophthalmitis, and internal jugular vein thrombophlebitis. He was transferred operating theater (OT) for wound debridement and shifted to the intensive care unit (ICU), where he was treated for septic shock and multiorgan failure. Despite persistent fever and resistance to treatment, a multidisciplinary team approach in the management resulted in notable improvements in the treatment of the condition and favorable outcome that ended with successful decannulation of tracheostomy and better outcome of the overall condition. Conclusions: Lemierre’s syndrome is an uncommon condition with rising prevalence and high morbidity and mortality rates. Prompt diagnosis, infection elimination, and antibiotic treatment are crucial. A multidisciplinary approach reduces mortality rates, but anticoagulation therapy decision is debated.