Lemierre’s Syndrome - Pathophysiology


Lemierre’s is an infectious thrombophlebitis of the internal jugular vein.


 - It starts out as a common oropharyngeal infection, such as pharyngitis, tonsillitis, peritonsillar abscess, or dental infection.
 - But then if it goes untreated, it can spread to the parapharyngeal space (ie become a deep space neck infection), and get into the carotid sheath.


 - Once it penetrates the carotid sheath, it is only a matter of time before the patient becomes bacteremic and a clot forms in the IJ.   From there, septic emboli can fly throughout the body, landing in the liver, lungs, endocardium, and joints.


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