Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome

J Bras Pneumol. 2008 Dec;34(12):1079-83. doi: 10.1590/s1806-37132008001200015.
[Article in English, Portuguese]

Abstract

Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old female who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days). One month later, a computed tomography scan of the chest revealed resolution of the opacities.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Fusobacterium Infections / diagnosis*
  • Fusobacterium Infections / drug therapy
  • Humans
  • Jugular Veins*
  • Middle Aged
  • Pharyngitis / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / etiology*
  • Sepsis / microbiology
  • Syndrome
  • Thrombophlebitis / complications*
  • Tomography, X-Ray Computed