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Case Reports in Medicine
Volume 2010 (2010), Article ID 982494, 4 pages
http://dx.doi.org/10.1155/2010/982494
Case Report

A Unique Case of Lemierre Syndrome Associated with Thrombophilia in an Adult and the Role of Anticoagulation

1Department of Internal Medicine, University of Pittsburgh Medical Center, McKeesport, PA 15132, USA
2Division of Pulmonary, Allergy, and Critical Care Medicine, Montefiore University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA

Received 28 May 2010; Accepted 20 September 2010

Academic Editor: Gilles Z. Lugassy

Copyright © 2010 Pradeep H. Lakshminarayana and Matthew E. Woodske. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute septic thrombophlebitis of the internal jugular vein (IJV), better known as Lemierre syndrome, is a rare entity which poses several challenges in management. Treatment involves prompt use of intravenous antibiotics over a prolonged period of time, typically 6–8 weeks. The use of anticoagulation is controversial, but indicated for some. We describe the first reported case of Lemierre syndrome associated with a hypercoagulable state in an adult. We propose that all patients with Lemierre syndrome should be evaluated for hypercoagulable states and that the indications for anticoagulation in Lemierre syndrome are (1) propagation or nonresolution of IJV thrombus despite antibiotics and (2) identification of a hypercoagulable state, as in our case.