an unusual variant of lemierre’s syndrome with multiple abscesses and hepatic vein thrombosis

Introduction: lemierre’s syndrome is an uncommon, life-threatening disease that develops as a severe complication of oropharyngealinfection. however, this syndrome has also been reported during anaerobic septicemia, originating from diverse sourcesof infection, such as the gastrointestinal system. the diagnosis of this syndrome remains challenging, and is often prompted by thedetection of fusobacterium necrophorum in blood culture, rather than with clinical signs or symptoms.case presentation: a previously healthy 38-year-old woman was hospitalized for a 6-day history of fever, watery diarrhea, and vomiting.physical examination of the patient showed fever, pharyngitis, and diffuse abdominal tenderness. laboratory investigationsrevealed elevated inflammatory markers, and two blood cultures revealed fusobacterium necrophorum. an abdominal ultrasoundshowed a liver abscess and hepatic vein thrombosis. the thoracoabdominal and cerebral computed tomography scan confirmedthe results of the abdominal ultrasound. it additionally revealed bilateral lung nodules and a parietal brain abscess. the patient’sgeneral condition and her laboratory test results, improved after receiving treatment with ceftriaxone and metronidazole. she receivedantibiotics for three months, without anticoagulation therapy. repeated computed tomography scans showed a resolutionof the liver, pulmonary, and brain abscesses, as well as the recanalization of the hepatic vein.conclusions: lemierre’s syndrome emerges as a result of septic illness and liver abscesses in case of gastrointestinal symptomsdespite the lack of common presentation.