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Lemierre’s syndrome with cavernous sinus thrombosis caused by dental infection
  1. Peerawat Sukkul and
  2. Narongrit Kasemsap
  1. Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  1. Correspondence to Narongrit Kasemsap; naroka{at}


Lemierre’s syndrome is a rare multisystemic infection beginning in oropharynx commonly caused by oral anaerobic organisms and leading to internal jugular vein thrombosis with septic emboli. Here, we describe a 45-year-old woman with hypertension and unrecognised type 2 diabetes who presented to a community hospital with fever, double vision and septic shock. Examination showed neck pain aggravated by neck flexion, limited ocular movement of right lateral rectus, left medial rectus and left superior oblique and incomplete ptosis of the left eye. These symptoms were suggestive of bilateral cavernous sinus syndrome. CT of the brain showed bilateral proximal internal jugular vein and cavernous sinus thrombosis. CT angiography revealed septic emboli at both upper lungs. The patient had good improvement of neurological symptoms after dental extraction, intravenous antibiotic and anticoagulant.

  • infection (neurology)
  • dentistry and oral medicine

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  • Contributors Supervised by NK. Patient was under the care of PS and NK. Report was written by PS and NK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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