Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome.
Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old female who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days). One month later, a computed tomography scan of the chest revealed resolution of the opacities.
Silva
Denise Rossato
DR
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Gazzana
Marcelo Basso
MB
Albaneze
Ricardo
R
Dalcin
Paulo de Tarso Roth
Pde T
Vidart
Josi
J
Gulcó
Nei
N
D005260:Female; D005674:Fusobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007601:Jugular Veins; D008875:Middle Aged; D010612:Pharyngitis / Q000150:complications; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D018805:Sepsis / Q000382:microbiology; D013577:Syndrome; D013924:Thrombophlebitis / Q000150:complications*; D014057:Tomography, X-Ray Computed