Atypical Lemierre syndrome.

Background: Lemierre syndrome is a complication of oropharyngeal infection and consists of a combination of internal jugular vein septic thrombophlebitis with septicaemia and distant septic emboli (mainly in the lungs). We describe an atypical case with facial vein and anterior jugular vein thrombophlebitis.

Methods: A 34-year-old woman attended the emergency room with tonsillitis, left head and neck cellulitis, left facial vein thrombosis and lung abscesses. A diagnosis of atypical Lemierre syndrome was proposed and the patient was treated surgically (neck incision and tonsillectomy) and medically (antibiotics, hyperbaric oxygen therapy and anticoagulation) allowing cure without sequelae.

Conclusions: Lemierre syndrome, a rare but serious complication requiring immediate treatment, should be investigated (by blood cultures and chest CT scan) in the presence of neck vein thrombosis complicating oropharyngeal infection.