{
  "abstract": "Patient: Male, 25-year-old\n\nFinal Diagnosis:\n\nStreptococcus constellatus\n\n-associated Lemierre syndrome with left internal jugular vein thrombosis, cavitating septic pulmonary emboli, empyema, and pulmonary abscess\n\nSymptoms: Dyspnea • fever • hemoptysis • productive cough\n\nClinical Procedure: —\n\nSpecialty: General and Internal Medicine\n\nObjective: Rare disease\n\nBackground: Lemierre syndrome is a rare septic thromboembolic disorder. Although historically associated with Fusobacterium necrophorum, non-fusobacterial cases caused by Streptococcus constellatus can present with dominant thoracic sepsis and delayed recognition.\n\nCase Report: A 25-year-old previously healthy man from northern Ecuador presented with 7 days of dyspnea, productive cough, fever, and hemoptysis, with profound hypoxemia and respiratory distress. Chest computed tomography showed bilateral cavitating septic pulmonary emboli and necrotizing pulmonary infection, and cervical vascular imaging confirmed left internal jugular vein thrombosis. One blood culture set grew Streptococcus constellatus susceptible to penicillin and ceftriaxone; sputum and pleural fluid cultures were sterile. He required intensive care, endotracheal intubation, empiric piperacillin-tazobactam plus vancomycin, escalation to meropenem plus vancomycin during clinical deterioration while resistant or polymicrobial infection was considered, therapeutic anticoagulation, and 2 video-assisted thoracoscopic procedures for empyema and a subsequent pulmonary abscess. After 4 weeks of intravenous antibiotics, he improved and was discharged on a direct oral anticoagulant for 1 additional month, remaining asymptomatic at short-term follow-up.\n\nConclusions: Lemierre syndrome should be considered in young adults with severe sepsis and multifocal cavitating lung lesions, even without pharyngeal symptoms. Empiric therapy should initially cover oral aerobes and anaerobes; once penicillin-susceptible Streptococcus constellatus is confirmed and no co-pathogen is recovered, de-escalation to targeted beta-lactam therapy, such as penicillin G or ceftriaxone, should be considered together with drainage of empyema or abscess when present.",
  "abstract_shown": true,
  "affiliations": [
    "Pontificia Universidad Católica del Ecuador, Quito, Ecuador",
    "Centro de Investigación para la Salud en América Latina (CISeAL), Quito, Ecuador"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Andre Fierro-Mosquera",
      "orcid": "0009-0006-5858-5250"
    },
    {
      "affs": [
        0
      ],
      "name": "Camila Perez-Guerron",
      "orcid": "0009-0003-7483-821X"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jordan Llerena-Velastegui",
      "orcid": "0009-0002-4246-0980"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ruth Jimbo-Sotomayor",
      "orcid": "0000-0001-5016-3834"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xavier Sanchez",
      "orcid": "0000-0002-8258-8746"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1j8zweb4ag3c9.bib",
  "cited_by": 0,
  "doi": "10.12659/ajcr.953543",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712045/",
  "id": "1j8zweb4ag3c9",
  "issns": [
    "1941-5923"
  ],
  "landing_url": "https://doi.org/10.12659/ajcr.953543",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Articles"
    ],
    [
      "openalex",
      "2725|Otolaryngology and Infectious Diseases"
    ]
  ],
  "openalex": "W7212152482",
  "pdf_url": "https://amjcaserep.com/download/inPress/idArt/953543",
  "pmcid": "PMC13712045",
  "pmid": "42921992",
  "published": "2026-10-23",
  "publisher": "International Scientific Information, Inc.",
  "ris": "https://research.draconitic.com/paper/1j8zweb4ag3c9.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:42Z",
      "native_id": "PMC13712045",
      "source": "pmc",
      "url": "https://doi.org/10.12659/ajcr.953543"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Otolaryngology and Infectious Diseases",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Streptococcus constellatus–Associated Lemierre Syndrome Presenting With Cavitating Septic Pulmonary Emboli Managed by Video-Assisted Thoracoscopy",
  "title_text": "Streptococcus constellatus–Associated Lemierre Syndrome Presenting With Cavitating Septic Pulmonary Emboli Managed by Video-Assisted Thoracoscopy",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:42Z",
  "url": "https://research.draconitic.com/paper/1j8zweb4ag3c9",
  "venue": "The American Journal of Case Reports",
  "versions": []
}