Lemierre's Syndrome in Pediatric Patients: Case Report

Introduction: Lemierre's syndrome is a severe and extremely rare septic thromboembolic event of an infection usually located in the neck and head. It is a rapidly progressive disease that can cause fatal consequences when there is no timely treatment. Clinical Case: A 6-year 5-month old female patient was evaluated due to a clinical picture of a continuous burning pain in the left anterior cervical region of moderate intensity of 3 weeks of evolution that worsens with a sudden mass growth at the mentioned level. Physical examination revealed an asymmetric neck with limited mobility due to the presence of an oval mass of approximately 6 cm in diameter located in the left anterior cervical quadrant. A CT scan showed an invasive process in the left infrahyoid region that is enhanced with the use of intravenous contrast medium, measuring 4.7 cm x 3.8 cm x 4.2 cm, with an approximate volume of 39 ml. In addition, a hypodense image is observed in the left internal jugular vein suggesting thrombosis. Drainage of a cervical abscess is performed, revealing a mass in the left external segment. The result of the study of the collected purulent fluid reports isolation of two types of germs: Bacteroides fragilis and Peptococus species. Considering also the radiological finding of the internal jugular vein thrombosis, anticoagulation with low molecular weight heparins was started. Patient with good evolution of clinical picture. Conclusions: Lemierre's Syndrome is a disease in which early diagnosis and treatment can reduce morbidity and mortality, especially in pediatric patients, where its incidence is extremely rare. However, specific clinical data can guide us to its diagnosis.