Medicine (Baltimore). 2026 Jan 9;105(2):e46988. doi: 10.1097/MD.0000000000046988.
ABSTRACT
RATIONALE: Lemierre syndrome (LS) is a rare but life-threatening complication of acute oropharyngeal infections. It is characterized by septic thrombophlebitis of the internal jugular vein and subsequent metastatic abscess formation. The most common causative pathogen of LS is Fusobacterium necrophorum (FN). This paper presents the case of a 17-year-old female patient with LS, in whom FN was rapidly detected and LS was diagnosed using targeted next-generation sequencing (tNGS) combined with metagenomics capture (MetaCAP). This approach enabled timely detection of FN and guided appropriate treatment.
PATIENT CONCERNS: The patient, a female 17-year-old student, experienced a fever after catching a cold, with a peak temperature of 39.8 °C on May 22, 2024, accompanied by chills and shivering, sore throat, right chest pain, back pain, cough, and hemoptysis.
DIAGNOSES: The patient was initially diagnosed with non-severe community-acquired pneumonia at admission on May 26, 2024. She was finally diagnosed with LS after FN was detected using bronchoalveolar lavage fluid tNGS combined with serum MetaCAP.
INTERVENTIONS: The patient received targeted antimicrobial therapy and thorough thoracic drainage in the shortest time after being definitely diagnosed with LS using tNGS and MetaCAP technologies.
OUTCOMES: The clinical symptoms of the patient were significantly improved. A chest computed tomography scan on July 15, 2024 indicated complete resolution of exudates and solid lesions in both lungs.
LESSONS: This case underscores the significant role of tNGS combined with MetaCAP in the early detection of FN and timely diagnosis of LS, systematically explores the epidemiology, clinical features, diagnosis and treatment of LS, thus providing a reference for clinicians to rapidly diagnose and treat LS.
PMID:41517763 | DOI:10.1097/MD.0000000000046988