Pulmonary embolism and internal jugular vein thrombosis as evocative clues of Lemierre’s syndrome: A case report and review of the literature

• Published in: World journal of clinical cases Vol. 5; no. 3; pp. 112 - 118
• Main Authors: Giorgi, Alfredo De, Fabbian, Fabio, Molino, Christian, Misurati, Elisa, Tiseo, Ruana, Parisi, Claudia, Boari, Benedetta, Manfredini, Roberto
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 16.03.2017
• Subjects: Case Report; Pulmonary embolism; Fusobacterium species; Systemic septic embolization; Lemierre’s syndrome; Internal jugular vein thrombosis
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v5.i3.112

Lemierre's syndrome (LS) is an uncommon condition with oropharyngeal infections, internal jugular vein thrombosis, and systemic metastatic septic embolization as the main features. Fusobacterium species, a group of strictly anaerobic Gram negative rod shaped bacteria, are advocated to be the main pathogen involved. We report a case of LS complicated by pulmonary embolism and pulmonary septic emboli that mimicked a neoplastic lung condition. A Medline search revealed 173 case reports of LS associated with internal jugular vein thrombosis that documented the type of microorganism. Data confirmed high prevalence in young males with Gram negative infections (83.2%). Pulmonary embolism was reported in 8.7% of cases mainly described in subjects with Gram positive infections (OR = 9.786; 95%CI: 2.577-37.168, = 0.001), independently of age and gender. Only four fatal cases were reported. LS is an uncommon condition that could be complicated by pulmonary embolism, especially in subjects with Gram positive infections.