Lemierre syndrome: a hidden complication
of sore throats

Lemierre syndrome: a hidden complication
of sore throats

Lemierre syndrome, Thrombophlebitis, Klebsiella pneumoniae, Neck swelling, Septic emboli, Antibiotic
stewardship

Background Lemierre syndrome is a rare but potentially life-threatening condition characterized by septic thrombo-
phlebitis of the internal jugular vein, most commonly caused by Fusobacterium necrophorum.

Case presentation A 46-year-old woman with no significant medical history presented with generalized neck swell-
ing and fever. Despite seeking medical attention at multiple outpatient clinics for upper respiratory symptoms lasting

10 days, she only received symptomatic treatment for acute viral pharyngitis. A computed tomography (CT) scan

of her neck revealed thrombophlebitis in the left internal jugular vein, and subsequent cultures indicated the pres-
ence of Klebsiella pneumoniae. The patient’s oxygen saturation levels suddenly dropped, and the CT scan identified

bilateral peripheral consolidation areas in both lungs, consistent with septic emboli. These findings were consistent
with a diagnosis of Lemierre syndrome. The patient was treated with 2 weeks of intravenous piperacillin/tazobactam
and vancomycin, as well as anticoagulation therapy using heparin, and her symptoms resolved completely.

Conclusion This report presents an unusual occurrence of Lemierre syndrome caused by K. pneumoniae, a less fre-
quently encountered causative pathogen in patients without diabetes mellitus. The case highlights the significance

of timely and appropriate antibiotic use to prevent potential complications.
Keywords Lemierre syndrome, Thrombophlebitis, Klebsiella pneumoniae, Neck swelling, Septic emboli, Antibiotic
stewardship

Naheel A. AlAmer1* and Wasan F. AlMarzouq2

https://doi.org/10.1186/s12245-023-00524-x

2023

Peri Irawan

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