Lemierre’s syndrome associated with acute osteomyelitis: A case report and review of the literature

Abstract

Odontogenic infection is the most common cause of necrotizing fasciitis of the head and neck, and underlying diseases, time to surgery, and spread of inflammation to the mediastinum are significant prognostic factors. Among them, jugular vein thrombophlebitis due to spread of a primary infection via the cervical fascia or cervical lymphatic system is rare. Herein, we report a case of Lemierre’s syndrome (LS) as a complication of a severe odontogenic infection in a patient who refrained from medical examinations for several years.

A 43-year-old man was referred to our hospital with pain and swelling in the left mandible. Based on the clinical and imaging findings, the patient was diagnosed with acute osteomyelitis, complicated with cervical cellulitis and LS. Multiple external jugular vein thromboses and distant infections were observed. Surgical drainage, sequestrectomy for mandibular osteomyelitis, and tooth extraction were performed, and antibiotics were administered for 9 weeks. No evidence of infection was observed 1 year after surgery.