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Lemierre syndrome: a diagnostic dilemma of critical care in the post-COVID era
  1. Akhya Sharma1,
  2. Zubin Mahajan1,
  3. Sameera Mehta2 and
  4. Aditi Puri1
  1. 1Internal Medicine, Loyola University Chicago, Chicago, Illinois, USA
  2. 2Pathology, Smt Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
  1. Correspondence to Dr Akhya Sharma; akhya.sharma{at}


Lemierre syndrome (LS) is referred to as the ‘forgotten Disease’ owing to its rarity in the postantibiotic era with an estimated yearly incidence of 1/million population. The classic triad of LS includes internal jugular vein thrombosis, oropharyngeal infection and metastatic septic emboli. We present a case of typical LS with Fusobacterium and Prevotella infection, presenting with peritonsillar abscess and jugular vein thrombosis complicated by sepsis, acute hypoxic respiratory failure due to multiple pulmonary emboli and severe thrombocytopaenia in the absence of disseminated intravascular coagulation.

  • COVID-19
  • Infectious diseases
  • Intensive care
  • Pneumonia (respiratory medicine)
  • Thrombosis

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  • Contributors AS and ZM wrote the draft of the manuscript. The manuscript was critically reviewed by AP and important editing and additions were made to include essential intellectual components. AS and ZM were involved actively in the patient management. SM was involved in reviewing the pathological and microbiological specimens and aiding in diagnosis.

  • 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.