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CASE REPORT
Lemierre’s syndrome: a pain in the neck with far-reaching consequences
  1. Thomas James Stubington1,
  2. Paul James2
  1. 1ENT, Queen’s Medical Centre Nottingham, Nottingham, UK
  2. 2Critical Care, Queen’s Medical Centre Nottingham, Nottingham, UK
  1. Correspondence to Mr Thomas James Stubington, thomas.stubington{at}gmail.com

Summary

Lemierre’s syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection. Treatment comprised antibiotic therapy, anticoagulation and fluid resuscitation, and was carried out in a high dependency unit setting. At follow-up 3 months after discharge, the patient was well with no residual symptoms off all treatment. During the events of this case, it became apparent that while ear, nose and throat and infectious diseases team members were relatively familiar with the condition, other departments including the critical care team were less so.

  • ear, nose and throat/otolaryngology
  • intensive care
  • infectious diseases
  • otolaryngology/ENT
  • vascular surgery

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Footnotes

  • Contributors TJS reviewed the patient’s medical notes, conducted the literature review and wrote the manuscript. PJ reviewed the manuscript, provided editorial advice and assisted in placing the case In a critical care context.

  • Competing interests None declared.

  • Patient consent Obtained.

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