Lemierre Syndrome Presenting as Tender Goiter

Internal jugular vein (IJV) thrombosis, also known as Lemierre syndrome (LS), is a potentially dangerous complication that follows oropharyngeal infections. It has also been documented in individuals with cervical lymph node infection, thyroid abscess, and pharyngeal abscess. LS is potentially a catastrophic complication and, if not detected and treated early, can lead to mortality. This case report describes an older woman who presented with a history of fever, odynophagia, and swelling in the anterior aspect of her neck for 20 days. Examination revealed a severely congested posterior pharyngeal wall with bilateral tonsillitis and a tender goiter. Further investigations revealed a diagnosis of LS. The patient was appropriately managed with higher antibiotics and anticoagulation. This case report highlights the importance of IJV thrombosis, which can present as a thyroid swelling.