Lemierre's syndrome complicating bacterial pharyngitis in a patient with undiagnosed factor XII deficiency

Internal jugular vein thrombosis occurs as an uncommon complication of oropharyngitis. The following case report describes a previously healthy adult woman who presented with sore throat, left ear pain, and fever. She was initially diagnosed with pharyngitis and inadvertently had blood cultures sent as part of her workup. She was then called back to the Emergency Department the following day for positive growth of the blood culture, and found to have thrombophlebitis of the internal jugular vein on computed tomography scan of the neck. Further workup revealed factor XII deficiency. The clinical course was further complicated by septic pulmonary emboli and disseminated intravascular coagulation. The patient was treated with broad-spectrum antibiotics and anticoagulation and made a full recovery.