From a sore throat to Lemierre syndrome. A case report and literature review

A 17-year-old male patient presented to our emergency department for fever, persistent sore throat and right-sided neck pain despite antibiotics, and dehydration. He was found to have thrombosis of the right facial vein and diffuse septic emboli. Blood culture tested positive for Fusobacterium necrophorum, leading to a diagnosis of Lemierre Syndrome (LS). LS is a life-threatening condition characterized by thrombosis of the internal jugular vein, anaerobic bacteraemia, and diffuse septic emboli. It should be suspected in healthy young patients who present with persistent sore throat or atypical lateral cervical pain, followed by sepsis and bronchopneumonia. Diagnosis is confirmed through the identification of jugular venous thrombosis and is supported by the growth of anaerobic bacteria in blood cultures. Treatment is based on prolonged targeted antibiotic therapy and hydration. The indication for anticoagulant therapy remains a topic of debate. Our patient was treated with antibiotics and anticoagulant therapy, resulting in a good clinical response and subsequent complete recovery.

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