ABSTRACT
We report a case of Fusobacterium nucleatum (F. nucleatum) empyema in a 34-year-old male with no significant past medical history or obvious risk factors who presented with shortness of breath and chest pain. His imaging showed complicated parapneumonic effusion which grew F. nucleatum. He was started on piperacillin-tazobactam. The patient's clinical condition deteriorated despite initial therapeutic efforts, leading to escalated antibiotic therapy and further investigations. The patient's subsequent clinical course included pigtail catheter placement with drainage of fluid requiring tpa and dornase alpha, leading to significant improvement and eventual discharge on oral amoxicillin-clavulanic acid.
ABSTRACT
Lemierre's syndrome is a condition when an oropharyngeal infection, typically from Fusobacterium necrophorum, causes thrombophlebitis of the internal jugular vein. There have been few case reports of Lemierre's syndrome affecting the external jugular vein, but to our knowledge, this is the first case report where COVID-19 infection is the prime suspect for causing this syndrome. SARS-CoV-2 infection, known to cause hypercoagulability and immunosuppression, increases the risk of deep venous thrombosis and secondary infections. We report a case of a young male with no known risk factors who developed Lemierre's syndrome as a complication of COVID infection.
