Necrotizing Lip Infection Causing Septic Thrombophlebitis of the Neck: A Rare Variant of Lemierre’s Syndrome

Publication date: Available online 2 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Karl Cuddy, Nariman Saadat, Baber Khatib, Ashish Patel
BackgroundLemierre's syndrome is an uncommon condition where internal jugular vein thrombosis presents after recent oropharyngeal infection. Frequently, this is accompanied by septic emboli. This report outlines a variant of this disease process, with septic thrombophlebitis of the neck associated with necrotizing skin infection of the lower lip and chin.Methods and ResultsA 25 year old male with lower lip and chin swelling, initially managed with intravenous antibiotics progressed to develop a left facial vein thrombus, septic emboli to the lungs and a necrotizing lower lip and chin infection which was managed with debridement, thrombectomy and prolonged hemodynamic and pulmonary support.ConclusionNecrotizing skin infection with thrombus of the jugular system and septic emboli is a very rare variant of Lemierre's syndrome. Early recognition of an infection with septic emboli and/or necrotizing pathobiology allows for prompt antibiotic and surgical therapy, minimizing the mortality of these potential lethal infections.



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