Laila Benjelloun, Ayman El Farouki, Bouchra Taleb
Oral Surgery Department, Mohamed V University of Rabat, Faculty of Dentistry, Avenue Mohamed El Jazouli, 6212 Madinat Al Irfane, Rabat, Morocco.
Radiology Department, Mohamed V Military Hospital, Av. Abderrahim Bouabid, Rabat, Morocco.
Int J Surg Case Rep. 2025 Jul;132:111457. doi: 10.1016/j.ijscr.2025.111457. Epub 2025 May 20.
Lemierre syndrome is characterized by clinical or radiographic signs of thrombosis of the internal jugular vein, distant infected emboli and the presence of anaerobic pathogens, usually Fusobacterium necrophorum. It can be the result of a recent infection in the area of the head or neck, mostly in the form of pharyngitis or tonsillitis. It can also result from less common conditions, such as odontogenic infections which is rarely reported in the dental literature.
This article reports the clinical case of a 69-year-old male patient with a persistent diffuse swelling in the facial and neck area with throat pain, associated to an odontogenic sinusitis, that was later diagnosed as Lemierre's syndrome caused by an impacted maxillary wisdom tooth.
Diagnosis of Lemierre syndrome is challenging. Suspicion of the disease is needed in cases of oropharyngeal infection followed by fever, tender swelling of the neck sore throat and dysphagia. Screening for thrombosis of the internal jugular vein may be quickly accomplished using ultrasonography; however, a computed tomography scan is more sensitive for identifying this entity. Successful management of this condition relies on knowledge of the condition and its prompt diagnosis. This usually needs surgical drainage and intravenous antibiotics. Anticoagulation is controversial.
Morbidity and mortality are significant with this syndrome, that is why diagnosis and early treatment are very important, and dentists should be familiar with this condition.
勒米尔综合征的特征为颈内静脉血栓形成的临床或影像学表现、远处感染性栓子以及厌氧病原体（通常为坏死梭杆菌）的存在。它可能是头颈部近期感染的结果，主要表现为咽炎或扁桃体炎。它也可能由较少见的情况引起，如牙源性感染，这在牙科文献中很少报道。
本文报告了一例69岁男性患者的临床病例，该患者面部和颈部持续弥漫性肿胀并伴有咽痛，与牙源性鼻窦炎有关，后来被诊断为由上颌阻生智齿引起的勒米尔综合征。
勒米尔综合征的诊断具有挑战性。对于口咽感染后出现发热、颈部压痛性肿胀、咽痛和吞咽困难的病例，需要怀疑该病。使用超声检查可快速完成颈内静脉血栓形成的筛查；然而，计算机断层扫描对识别该病症更敏感。成功治疗这种病症依赖于对该病症的了解及其及时诊断。这通常需要手术引流和静脉使用抗生素。抗凝治疗存在争议。
该综合征的发病率和死亡率都很高，这就是为什么诊断和早期治疗非常重要，并且牙医应该熟悉这种病症。
