Title : Septic thrombophlebitis and embolic complications in an 18-year-old: a rare case of reverse Lemierre’s syndrome
Abstract:
This report describes a rare instance of an 18-year-old male presenting with a history of right knee strain who developed fever, pain, and difficulty walking. The patient was first evaluated for suspected sepsis complicated by polyarthralgia. He later developed worsening respiratory symptoms and was referred to our center. Imaging studies revealed significant findings, including an MRI of the right lower limb showing edema and collection in the vastus lateralis and an ultrasound confirming deep venous thrombosis in the right distal saphenofemoral and popliteal veins. Culture results from the right thigh abscess grew Staphylococcus aureus. A chest X-ray revealed bilateral peripheral opacities, which were subsequently confirmed as septic emboli on a computed tomography pulmonary angiogram. These findings were indicative of a rare presentation of Reverse Lemierre’s syndrome secondary to pyomyositis with septic thrombophlebitis and pulmonary septic embolism. This case highlights the importance of recognizing reverse Lemierre’s syndrome as a potential diagnosis in young patients presenting with sepsis, pyomyositis, and respiratory symptoms, particularly in the context of musculoskeletal infections.
