Lemierre syndrome, an overlooked but re-surfacing disease

Abstract

Lemierre’s syndrome is a rare head and neck condition that starts as an infection, typically in the ENT, and can progress to septic thrombophlebitis. It may include the jugular vein, facial vein, and respiratory tract. (1) It usually occurs as a complication of a bacterial throat infection The thrombophlebitis is a serious condition and can result in further systemic complications such as bacteremia or septic emboli. Recent evidence indicates that its prognosis is still grim even after a century from its first report, with significant rates of in-hospital complications, mortality, and long-term sequelae. Its management has no specific guidelines except for standard antibiotic stewardship, with an ongoing debate on the role of therapeutic-dose (2).

We present the case of a 9-year-old boy with a history of oral cavity and palate, fever and severe respiratory distress, left-sided tension pneumothorax on chest X-ray, emergency intervention, and tomography that showed internal. carotid artery Venous thrombosis extended to the brachiocephalic vein and resulted in bilateral septic embolism with central pleural effusion, left pneumothorax and right abducens nerve palsy. The patient also complained of pain and discharge in the right ear for the last 3 months.