# Lemierre Syndrome With Atypical Cardiological Involvement and Fatal Outcome

## TL;DR

This paper reports a rare and fatal case of Lemierre syndrome with unusual heart involvement in a 35-year-old man.

## Contribution

The case highlights atypical cardiological features and rapid deterioration in Lemierre syndrome.

## Key findings

- The patient showed septic emboli, mediastinal empyema, and pulmonary embolism.
- Despite treatment, the patient's condition worsened and resulted in death.
- The case underscores the need for early detection and awareness of Lemierre syndrome.

## Abstract

Lemierre syndrome, an uncommon but potentially fatal condition, begins in the throat, usually in the area surrounding the tonsils or pharynx, spreading to other parts of the body. Septic thrombophlebitis, marked by the blood clots in veins due to bacterial infection, is the hallmark of Lemierre syndrome. We describe a case of a 35-year-old male patient who presented with a sore throat, hoarseness, and swelling on the right side of the face and neck for one week, followed by a sudden onset of shortness of breath for one day. His condition deteriorated rapidly, and he was intubated and moved to the Intensive Care Unit. There was no recorded fever or history of fever. A moderate pericardial effusion was discovered by bedside echocardiogram. A computed tomography (CT) scan showed bilateral consolidation, septic emboli, mediastinal empyema, pulmonary embolism, and thrombosed veins. A positive blood culture for Bacteroides species confirmed the diagnosis of Lemierre syndrome. The patient's health worsened even with vigorous treatment, and, unfortunately, he passed away. Clinicians should maintain a high level of suspicion for this disease in patients with bacterial infection symptoms, especially originating in the head and neck regions, as well as in patients presenting with swelling of the neck. This report aims to provide valuable insights into the complexities of Lemierre syndrome, prompting further research and awareness to enhance early detection and improve outcomes for such critical individuals.