Lemierre’s Syndrome Presenting with Multisystem Complications in a Child: A Case Report and Literature Review

TL;DR

A 6-year-old boy in Saudi Arabia developed a rare and deadly disease called Lemierre’s syndrome, which led to multiorgan failure despite treatment.

Contribution

This is the first reported case of Lemierre’s syndrome in Saudi Arabia, highlighting the importance of early diagnosis and multidisciplinary care.

Findings

The patient presented with septic shock, fever, leg swelling, and mandibular swelling.

Despite appropriate treatment, the child died from multiorgan failure.

Early recognition and multidisciplinary management are critical for improving outcomes in Lemierre’s syndrome.

Abstract

Background and Clinical Significance: Lemierre’s syndrome, also known as the “forgotten disease”, is a rare clinical syndrome of septic thrombophlebitis associated with morbidity and mortality. This study reports on a 6-year-old boy diagnosed with Lemierre’s syndrome, providing an in-depth case analysis and a comprehensive review of the current literature on this uncommon condition. Case Presentation: A 6-year-old boy was admitted to the pediatric intensive care unit (PICU) with septic shock, presenting with a high-grade fever of 39.5 °C for 10 days and swelling in the left leg for one week. Additionally, he had a history of swelling in the left mandibular area for five days and a skin rash. His recent medical history was unremarkable, except for decreased activity and oral intake over the past three days. Both his neonatal and past medical histories were unremarkable. Upon admission to the PICU, a multidisciplinary team was assembled to address his condition. Following a comprehensive history, physical examination, and relevant investigations, the child was diagnosed and managed as a case of Lemierre’s syndrome—the first reported case in Saudi Arabia. Treatment included antibiotics, unfractionated heparin infusion, and analgesics. Family members were counseled on the nature, severity, and prognosis of the disease. Despite the optimal treatment given to this patient, the patient died from multiorgan failure as a complication of the disease after an eight-day stay in the PICU. Conclusions: This paper reports the main presenting features and the workup of a 6-year-old male child diagnosed and managed as a case of Lemierre’s syndrome in the Saudi Arabian context. The early recognition of the symptoms of Lemierre’s syndrome and introduction of appropriate treatment in multidisciplinary teamwork are crucial to improve the outcomes of such a life-threating syndrome.

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