# Lemierre's Like Syndrome: Retropharyngeal Abscess With Internal Jugular and Cerebral Venous Thromboses and Septic Embolization Leading to Pulmonary Embolism and Cerebral Abscesses Complicated by Papilledema and Residual Sixth Cranial Nerve Palsy

## TL;DR

A child with a throat abscess developed severe complications including blood clots and brain abscesses, highlighting the importance of early diagnosis and treatment.

## Contribution

This case report presents a rare and severe progression of retropharyngeal abscess with multiple life-threatening complications.

## Key findings

- The child developed bilateral internal jugular and cerebral venous thromboses from a retropharyngeal abscess.
- Septic embolism led to pulmonary embolism and cerebral abscesses, with residual cranial nerve palsy at 24 months.
- Early diagnosis and management are critical to prevent severe complications in such cases.

## Abstract

A male child with a history of sinusitis presented to the emergency medicine department with a high fever, neck swelling, headache, vomiting, and double vision. He was diagnosed with retropharyngeal abscess (RPA) with bilateral internal jugular vein (IJV) and cerebral venous thromboses. The child was treated promptly and transferred to a specialty center, where the abscess was drained. However, he developed papilledema and septic embolism, leading to pulmonary embolism and cerebral abscesses. The child was an inpatient for six weeks and had outpatient treatment for three months. He developed exotropia due to bilateral sixth cranial nerve palsy. This existed even at the 24-month follow-up. This case report highlights the rare complications and morbidity from the retropharyngeal abscess. It also emphasizes the early diagnosis and management options in a busy emergency medicine department.