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  • Atypical presentation of Lemierre’s syndrome caused by penicillin-susceptible Staphylococcus aureus in a patient with chronic stomatitis and COVID-19

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Infectious Diseases
Atypical presentation of Lemierre’s syndrome caused by penicillin-susceptible Staphylococcus aureus in a patient with chronic stomatitis and COVID-19
  1. Emma Burgdorf1,
  2. Janni Jensen1,2,
  3. Peter Grimm1 and
  4. Sebastian von Huth3
  1. 1Department of Radiology, Odense Universitetshospital, Odense, Syddanmark, Denmark
  2. 2Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Syddanmark, Denmark
  3. 3Department of Infectious Diseases, Odense Universitetshospital, Odense, Syddanmark, Denmark
  1. Correspondence to Ms Janni Jensen; janni.jensen{at}rsyd.dk

Abstract

A healthy man in his late 20s was admitted to the emergency department due to a flare-up in his severe chronic stomatitis, along with flu-like symptoms. CXR showed multiple bilateral consolidations and subsequent CT revealed thrombosis of the left facial and internal jugular vein, together with septic embolism in both lungs. Blood cultures showed penicillin-susceptible Staphylococcus aureus. The patient was diagnosed with Lemierre’s syndrome, despite atypical bacteria and clinical presentation. During hospitalisation, he developed pulmonary empyema as a complication and was admitted for 4 weeks. During hospitalisation and after discharge, the patient was examined for multiple rheumatic, immunological and dermatological diseases, but no underlying cause for Lemierre’s syndrome has been found. We present this case due to the rarity of its nature, with atypical clinical presentation and pathogen for Lemierre’s syndrome, but with classic radiological findings.

  • Radiology
  • Infectious diseases

https://doi.org/10.1136/bcr-2023-258776

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: EB was responsible for drafting the manuscript. JJ, PG and SvH all contributed to the manuscript and critically reviewed it. All authors approved the final version of the manuscript. The following authors gave the final approval of the manuscript: all authors.

    • 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.