SHM Converge Scientific Abstract ePoster Gallery-Just a Sore Throat? A Case of Lemierre's Syndrome, a Serious Complication of Pharyngitis

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This case describes a 22-year-old man who developed Lemierre’s syndrome after a recent pharyngitis. He presented with five days of fever and acute confusion, along with hypotension, tachycardia, neck tenderness, and respiratory findings. Initial labs showed leukocytosis, and CT imaging of the chest revealed right middle lobe pneumonia with cavitary nodular lesions consistent with septic emboli. He was started on broad-spectrum antibiotics.

Further workup showed no cardiac vegetations on echocardiogram, but blood cultures grew <strong>Fusobacterium necrophorum</strong>, a classic cause of Lemierre’s syndrome. CT neck and venous Doppler confirmed <strong>right internal jugular vein thrombosis and thrombophlebitis</strong>. During hospitalization, he also developed a large triceps abscess requiring surgical drainage. Repeat chest imaging demonstrated bilateral septic emboli, necrotizing pneumonia, and pleural effusions. Thoracic surgery and interventional pulmonology recommended conservative management. After 14 days of IV antibiotics, he improved and was discharged on six weeks of oral amoxicillin/clavulanate.

The report emphasizes that Lemierre’s syndrome is a rare but serious complication of oropharyngeal infection, typically affecting young adults. It is characterized by bacteremia, internal jugular vein thrombophlebitis, and septic emboli, most often to the lungs. Persistent fever or worsening symptoms after pharyngitis should prompt urgent evaluation. Management usually involves prolonged antibiotics; anticoagulation remains controversial and is not clearly beneficial. Mortality remains significant despite treatment.

Asset Subtitle

Jennifer L. Spiegel

Meta Tag

Author List Dhruval Amin, Elizabeth Aherne, Hau Nguyen, Jennifer L. Spiegel, Morgan Groover, Oliver C. Marasigan

Category Clinical Vignettes

Concept Lemierre Syndrome

Concept Fusobacterium necrophorum

Concept Internal Jugular Vein Thrombosis

Concept Thrombophlebitis

Concept Septic Pulmonary Emboli

Distinguished Non-Finalist

Presenter Organization University of Massachusetts Chan Medical School

Presenting Author Jennifer L. Spiegel

Track Adult

Keywords

Lemierre syndrome

Fusobacterium necrophorum

pharyngitis

internal jugular vein thrombosis

thrombophlebitis

septic emboli

necrotizing pneumonia

bacteremia

young adults

prolonged antibiotics

Lemierre Syndrome

Fusobacterium necrophorum

Internal Jugular Vein Thrombosis

Thrombophlebitis

Septic Pulmonary Emboli