Lemierre Syndrome: Incidental Finding of Forgotten Fatal Disease as a Complication of Ludwig’s Angina

Abstract

Lemierre syndrome (LS) is a rare, life-threatening complication of oropharyngeal infections associated with septicemia and internal jugular thrombosis. Internal jugular vein thrombosis is an uncommon disease associated with central vein catheterization, intravenous drug abuse, hypercoagulability, trauma to the neck, infection, ovarian hyperstimulation syndrome (OHSS), and systemic infections. Here, we highlight a case of a 62-year-old women who presented progressively worsening neck swelling for three weeks, shortness of breath, and fever for four days. Her sepsis due to Ludwig’s angina was accompanied by septic pulmonary embolism and internal jugular vein thrombosis in keeping with a diagnosis of Lemierre syndrome. For this presentation of Lemierre syndrome, the treating physicians recommended surgical excision and drainage, followed by intravenous antibiotics and subcutaneous anticoagulation to treat septic emboli of the lungs and internal jugular veins. Sadly, after being informed about the procedure, the patient refused to consent, and four days later, she passed away. It is essential to remember that early detection and aggressive treatment may significantly impact prognosis and outcome.

Keywords:

• Lemierre syndrome
• internal jugular vein thrombosis
• septicemia
• Fusobacterium necrophorum
• emergency department

Data Sharing Statement

We declared that we had full access to all of the data in this study, and we take complete responsibility for the integrity of the data. All original data are available in the Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia. Data used to support the findings of this study are available from the corresponding author upon request.

Ethics Approval

Based on the regulations of the review board of the Mogadishu Somali Turkish Training and Research Hospital, institutional review board approval is not required for case reports.

Consent for Publication

Written informed consent had obtained by the patient and her mother to have the case details and any accompanying images published.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

We declare that we have no conflicts of interest.

Additional information

Funding

We declare that we have not received any financial support.