Bilateral Empyema in Lemierre’s Syndrome Due to Streptococcus pyogenes: An Atypical Presentation in an Immunocompromised Patient
- 1Hospital Medicine, Eastbourne District General Hospital, Eastbourne, GBR
Abstract
Lemierre’s syndrome (LS) is a rare yet severe condition that usually develops as a complication of oropharyngeal infection. Infection extends into the parapharyngeal space with subsequent septic thrombophlebitis of the internal jugular vein (IJV), which can result in septicaemia and metastatic lesions. Diagnosed cases of LS have significantly decreased with the introduction of antibiotics; however, several studies report ongoing incidence in recent years. The syndrome usually affects young, healthy individuals, and there is still an association with significant morbidity and mortality. In this report, we discuss an interesting case of a 56-year-old immunocompromised woman who presented with a parapharyngeal abscess and subsequently developed IJV thrombosis and bilateral multiloculated empyema requiring thoracoscopic debridement. The identified causative organism was Streptococcus pyogenes. There are few documented cases of LS in immunocompromised individuals or with Streptococcus organisms, as identified in this case. This presentation highlights the requirement of prompt imaging, intervention, and escalation of treatment for successful outcomes.
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BibTeX
@article{barden2026bilateral,
title = {{Bilateral Empyema in Lemierre’s Syndrome Due to Streptococcus pyogenes: An Atypical Presentation in an Immunocompromised Patient}},
author = {Amy Barden and Archana Balakrishnan and Namuna Sharma},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.118608},
url = {https://europepmc.org/article/PMC/PMC13723290},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bilateral Empyema in Lemierre’s Syndrome Due to Streptococcus pyogenes: An Atypical Presentation in an Immunocompromised Patient
AU - Amy Barden
AU - Archana Balakrishnan
AU - Namuna Sharma
PY - 2026
DA - 2026/10/26
JO - Cureus
DO - 10.7759/cureus.118608
UR - https://europepmc.org/article/PMC/PMC13723290
AB - Lemierre’s syndrome (LS) is a rare yet severe condition that usually develops as a complication of oropharyngeal infection. Infection extends into the parapharyngeal space with subsequent septic thrombophlebitis of the internal jugular vein (IJV), which can result in septicaemia and metastatic lesions. Diagnosed cases of LS have significantly decreased with the introduction of antibiotics; however, several studies report ongoing incidence in recent years. The syndrome usually affects young, healthy individuals, and there is still an association with significant morbidity and mortality. In this report, we discuss an interesting case of a 56-year-old immunocompromised woman who presented with a parapharyngeal abscess and subsequently developed IJV thrombosis and bilateral multiloculated empyema requiring thoracoscopic debridement. The identified causative organism was Streptococcus pyogenes. There are few documented cases of LS in immunocompromised individuals or with Streptococcus organisms, as identified in this case. This presentation highlights the requirement of prompt imaging, intervention, and escalation of treatment for successful outcomes.
SN - 2168-8184
ER -