Early diagnosis and treatment of lemierre syndrome in a neutropenic cancer patient

Lemierre syndrome (LS) is a rare but potentially life-threatening disease. It originates from an oropharyngeal infection of the internal jugular vein (IJV) leading to thrombophlebitis and metastatic infection. We report a 42-year-old woman with gastric adenocarcinoma presenting with febrile neutropenia, sore throat, and a tender induration in the left neck. Early LS was diagnosed by finding thrombophlebitis of the IJV following oropharyngeal infection but without bacteremia. Antibiotic treatment led to freedom from metastatic infection. Physicians should suspect LS after identifying the "red-flag" signs, i.e., tender induration of the unilateral neck following an oropharyngeal infection. A prompt diagnosis can be made by finding thrombophlebitis of the IJV. Early antibiotic therapy may lead to favorable clinical outcomes.