What question did this study set out to answer?

To describe an unusual case of Lemierre syndrome with significant central nervous system effects in an older male.

April 19, 2026Open Access

A case report of an atypical presentation of Lemierre syndrome with extensive central nervous system complications

Key Points

To describe an unusual case of Lemierre syndrome with significant central nervous system effects in an older male.
Case report design
Examination of clinical presentation and imaging findings
Utilization of contrast-enhanced computed tomography for diagnosis
Atypical case presented in a 75-year-old male
Extensive venous thrombophlebitis and bilateral cavernous sinus thrombosis observed
Findings included venous infarction and subarachnoid hemorrhage

Abstract

Lemierre syndrome (LS) is a rare but serious bacterial infection that originates in the oropharynx and is characterized by septic thrombophlebitis of the internal jugular veins. Septic emboli commonly affect other organs, such as the lungs, kidneys, and liver, with central nervous system (CNS) involvement being a rare occurrence. It predominantly affects young adults following an oropharyngeal infection with Fusobacterium species. We present an atypical presentation of LS in a 75-year-old male caused by Streptococcus intermedius, demonstrating extremely rare CNS involvement. Findings included extensive venous thrombophlebitis, bilateral cavernous sinus thrombosis, venous infarction, and subarachnoid hemorrhage. Radiographic imaging, particularly contrast-enhanced computed tomography (CT) scans, played a critical role in diagnosis and management. This case underscores the importance of maintaining a high index of suspicion for LS, especially in atypical presentations, and utilizing imaging for early diagnosis and intervention to improve patient prognosis.

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