OBJECTIVES:

To report, to the best of our knowledge, the youngest patient with Lemierre syndrome.

DESIGN:

Descriptive case report with review of the pediatric literature.

SETTING:

Pediatric intensive care unit in a tertiary referral hospital.

DATA SOURCE:

Systemic review of the literature, including PubMed (English-only journals) and major textbooks.

PATIENT:

We report a 5-month-old boy who presented with fever and a perforated left-sided otitis media. He developed left-sided complicated otitis media with retroauricular fluid collection, mastoiditis, and temporomandibular joint effusion. The clinical picture was complicated by a left internal jugular vein and left lateral sinus thrombosis. Fusobacterium necrophorum grew in the pus culture.

INTERVENTIONS:

Low molecular weight heparin.

MEASUREMENTS AND MAIN RESULTS:

No immunodeficiency and no thrombophilia were identified as predisposing conditions for Lemierre syndrome. Surgical drainage, early and adequate antibiotic treatment, and anticoagulation were followed by complete recovery.

CONCLUSIONS:

This case report illustrates that Lemierre syndrome can occur in infants without underlying risk factors for severe infections or thrombotic complications.