Lemierre’s syndrome is a rare but potentially fatal complication of acute oropharyngeal infection characterized by internal jugular vein septic thrombophlebitis and metastatic septic embolization. We report a case of a 40-year-old man who initially presented with symptoms consistent with a viral upper respiratory tract infection and mild sore throat that progressed over several days to fever, myalgia, and right-sided facial and cervical pain. Within 48 hours, he developed internal jugular vein thrombosis and septic emboli on ultrasound and confirmed on contrast-enhanced computed tomography, supporting a diagnosis of Lemierre’s syndrome. The patient was managed with intravenous antibiotics and anticoagulation, resulting in complete clinical recovery. This case highlights the diagnostic challenge posed by early nonspecific symptoms and emphasizes the need for a high clinical index of suspicion, swift recognition, early imaging, and early initiation of treatment to achieve favorable outcomes, particularly in settings where endemic infections may obscure the diagnosis of Lemierre’s syndrome.
Nallamothu et al. (Fri,) studied this question.