Bilateral Internal Jugular Vein Thrombosis: An Unusual Presentation of Lemierre Syndrome.
We present an unusual case of 54 years old lady suffering from Lemierre syndrome with bilateral internal jugular vein and carotid artery thrombosis with fatal outcome.
Lemierre syndrome is acute anaerobic oropharyngeal infection with secondary septic emboli
causing internal jugular vein thrombophlebitis and other metastatic infections. Septic emboli
may also cause infections in other organs like lungs, bones, joints and brain.
There was no known comorbidity. The patient had taken
treatment at another hospital.
On presentation, the patient was a febrile, oriented and
vitals were stable. There was a diffuse
swelling around neck. Video laryngoscopy revealed a
swelling in posterior pharyngeal wall
with normal larynx.
Drainage revealed no pus and patient was admitted
in intensive care unit. Haematological profile revealed
Total Leukocyte Count of 18400/mm3
with predominant polymorphs and serum creatinine of 2.4 mg%. Ultrasound abdomen showed
bilateral hydronephrosis with small left uretric calculus.
The septic emboli could be thrown by infection from
other extra pharyngeal sites like middle ear, female urogenital
tract and gastrointestinal tract. The septic emboli have been
identified in organs such as bone, meninges, abdominal viscera,
peritoneum and soft tissue.
Most cases of Lemierre syndrome have been described in young
males with ipsilateral Internal Jugular Vein thrombosis. Present case was
a middle aged woman who had retropharyngeal
abscess followed by bilateral internal jugular vein thrombosis
which has never been reported in literature. The prognosis in
bilateral IJV thrombosis remains poor.
Otolaryngol Open J. 2016; 2(2): 70-72. doi: 10.17140/OTLOJ-2-115
