SHM Converge Scientific Abstract ePoster Gallery-The "Forgotten Disease" That Should Not Be Forgotten

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This case report highlights Lemierre’s syndrome, a rare but serious complication of recent oropharyngeal infection. The syndrome is most commonly caused by <em>Fusobacterium necrophorum</em> and is characterized by septic thrombophlebitis of the internal jugular vein, with septic emboli often spreading to the lungs.

A 19-year-old healthy college student presented with 7 days of fever, chills, and sore throat. She was febrile and tachycardic, with bilateral anterior cervical lymphadenopathy. Initial testing for streptococcal infection, mononucleosis, and HIV was negative. CT imaging showed cervical lymphadenopathy and multifocal peripheral pulmonary opacities concerning for septic emboli. Blood cultures later grew <em>Fusobacterium necrophorum</em>. Subsequent ultrasound revealed an acute thrombus in the left internal jugular vein, confirming Lemierre’s syndrome. She was treated with 4 weeks of intravenous ceftriaxone and metronidazole, and repeat ultrasound 2 weeks later showed complete resolution of the thrombus.

The report emphasizes that Lemierre’s syndrome should be considered in patients with oropharyngeal sepsis, internal jugular vein thrombosis, and metastatic infection. Treatment requires prolonged antibiotics. The role of anticoagulation remains uncertain; current evidence does not show clear benefit, though some experts recommend it if the thrombus progresses despite adequate antibiotics. The authors suggest repeat ultrasound after 1–2 weeks of therapy to help guide anticoagulation decisions.

Asset Subtitle

Ali Farkhondehpour

Meta Tag

Author List Ali Farkhondehpour, Sandeep Segar

Category Clinical Vignettes

Concept Lemierre Syndrome

Concept Fusobacterium necrophorum

Concept Jugular vein thrombophlebitis

Concept Septic Emboli

Concept Antibiotic Therapy

Distinguished Non-Finalist

Presenter Organization University of California San Diego

Presenting Author Ali Farkhondehpour

Track Adult

Keywords

Lemierre syndrome

Fusobacterium necrophorum

internal jugular vein thrombosis

oropharyngeal infection

septic thrombophlebitis

septic emboli

pulmonary opacities

metronidazole

ceftriaxone

anticoagulation

Lemierre Syndrome

Fusobacterium necrophorum

Jugular vein thrombophlebitis

Septic Emboli

Antibiotic Therapy