Al-Anbagi Usamah, Hammouda Shahd, Al Hariri Bassem, Nashwan Abdulqadir J, Abusriwil Hatem M
Internal Medicine Department, Hazm Mebaireek General Hospital/Hamad Medical Corporation, Doha, QAT.
Medical Education Department, Hamad Medical Corporation, Doha, QAT.
Cureus. 2025 Sep 2;17(9):e91453. doi: 10.7759/cureus.91453. eCollection 2025 Sep.
Lemierre's syndrome (LS) is a rare but potentially fatal condition characterized by septic thrombophlebitis of the internal jugular vein (IJV), most often secondary to oropharyngeal infection. It is typically associated with and may lead to septic emboli, predominantly in the lungs. We report a rare case of a previously healthy 33-year-old man with LS complicated by extensive multivessel thrombosis, including the internal jugular, brachiocephalic, and superior vena cava (SVC) veins, with propagation of thrombus into the right atrium, in addition to septic pulmonary emboli. This constellation of findings is exceedingly rare and underscores the propensity of LS to extend beyond cervical veins into central thoracic and cardiac structures. Despite persistently negative blood cultures, likely due to prior antibiotic exposure, the diagnosis was established through clinical and imaging features. The patient was successfully managed with prolonged intravenous antibiotics, anticoagulation, and a multidisciplinary approach. This case emphasizes the importance of early recognition of atypical and extensive thrombotic complications in LS, as timely intervention can be lifesaving.
勒米尔综合征（LS）是一种罕见但可能致命的疾病，其特征为颈内静脉（IJV）发生脓毒性血栓性静脉炎，最常见于口咽感染继发。它通常伴有并可能导致脓毒性栓子，主要累及肺部。我们报告了一例罕见病例，一名33岁既往健康的男性患有勒米尔综合征，并发广泛的多血管血栓形成，包括颈内静脉、头臂静脉和上腔静脉（SVC），血栓蔓延至右心房，此外还有脓毒性肺栓塞。这一系列表现极为罕见，突显了勒米尔综合征易于从颈静脉延伸至胸中部和心脏结构的倾向。尽管由于先前使用过抗生素，血培养持续呈阴性，但通过临床和影像学特征确诊。该患者通过延长静脉抗生素治疗、抗凝治疗和多学科方法成功得到治疗。本病例强调了早期识别勒米尔综合征中非典型和广泛血栓并发症的重要性，因为及时干预可挽救生命。
