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Bilateral pterygoid abscesses in a patient with Lemierre’s syndrome
  1. Hidehiro Someko and
  2. Toshiaki Shiojiri
  1. General Internal Medicine, Asahi General Hospital, Asahi, Japan
  1. Correspondence to Hidehiro Someko; someko{at}


Patients with Lemierre’s syndrome may have complications such as lung lesions, large joint arthritis and central nervous system involvement. However, complications involving a pterygoid abscess have scarcely been reported. Here, we report a case of bilateral Lemierre’s syndrome accompanied with an intracranial epidural abscess and bilateral pterygoid abscesses. A woman in her 70s presented to the emergency room with a decreased level of consciousness. Infection was suspected, and Slackia exigua and species of Fusobacterium were identified in blood cultures, which suggested that the origin of infection was odontogenic, particularly as the patient had poor oral hygiene. Head and neck CT with contrast enhancement revealed bilateral internal jugular vein thrombophlebitis, septic pulmonary embolism, frontal epidural abscess and bilateral pterygoid abscesses. After antibiotic treatment and drainage, her condition improved. Pterygoid abscesses should be recognised as a rare complication of Lemierre’s syndrome, especially when the infection origin is odontogenic.

  • Dentistry and oral medicine
  • Infectious diseases

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  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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