Multidisciplinary Approach in Lemierre's Syndrome: A Case Report

Abstract

Fusobacterium necrophorum is an anaerobic, nonspore-forming, Gram-negative bacterium that can cause localized or systemic infection. Lemierre's syndrome, postanginal sepsis and necrobacillosis are among the systemic infections caused by F. necrophorum. Lemierre's syndrome is characterized by the development of internal jugular venous thrombosis and septic emboli following classical oropharyngeal infections in healthy young adults. In this case report, we present a 26-year-old female patient with a one-week history of back pain, shoulder pain, dyspnea and fever. She was intubated and admitted to the intensive care unit with symptoms of respiratory failure on the second day. She had high fever, leukocytosis, thrombocytopenia, cholestasis, and elevated bilirubin levels. Metastatic septic embolism in the patient's lungs, internal jugular vein thrombosis and a mycotic aneurysm were detected. After planning the treatment as meropenem, gentamicin, amphotericin B, multiseptal abscess foci were found between the paravertebral muscle plans and the deep neck fascia. In addition to antimicrobial treatment, recurrent surgical procedures were implemented. Lemierre's syndrome is a rare clinical entity which has a high rate of mortality. The present case was reported with the aim of reminding such an important disease and that early diagnosis and multidisciplinary approach is life-saving.