Clinical Practice and Cases in Emergency Medicine

Introduction: Lemierre syndrome is characterized by septic thrombophlebitis of the internal jugular vein, classically caused by Fusobacterium necrophorum. It is typically seen after an episode of pharyngitis where the palatine tonsils or peritonsillar mucosa is affected. It is thought to spread locally into the pharyngeal space toward the internal jugular vein.

Case Report: A 42-year-old male with progressively worsening, atraumatic right-sided neck pain was discovered to have methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, septic thrombophlebitis of the right dural venous sinuses, skull base osteomyelitis, and otomastoiditis.

Conclusion: While septic thrombophlebitis of the dural venous sinuses and internal jugular vein is typically caused by F necrophorum and usually comes from local pharyngeal spread, community-acquired MRSA is an emerging cause of this pathology.