Lemierre syndrome: case presentation of a life-threatening septic pneumonia with complicated parapneumonic effusion: A case report

Abstract

Rationale: Lemierre syndrome is a rare, life-threatening complication of oropharyngeal infections.

Patient concerns: A 35-year-old man started with an upper respiratory infection but worsened the clinical course with sepsis and acute respiratory failure with complicated bilateral pleural effusion.

Diagnoses: The patient was diagnosed with typical Lemierre syndrome with lung complications.

Interventions: Antibiotic therapy with bilateral pleural percutaneous drain with fibrinolysis.

Outcomes: The patient improved and was discharged without oxygen therapy after antibiotics were covered and active lung care with complicated parapneumonic effusion. After discharge, lung function showed restrictive lung defect but improved compared to the initial exam.

Lessons: Lemierre syndrome, which might begin as a mild upper respiratory infection, can progress to a critically ill disease accompanied by sepsis and metastatic septic embolus. The patient suffered septic lung emboli with bilateral complicated parapneumonic effusion but was successfully treated with percutaneous drainage with pleural fibrinolysis, appropriate antibiotics, and anticoagulants. Early suspicion of the disease and active treatment are necessary to treat rare syndromes like Lemierre syndrome.